D-二聚体对急性胰腺炎预后预测价值的Meta分析

Prognostic value of D-dimer in acute pancreatitis:A systematic review and meta-analysis

目的探讨D-二聚体对急性胰腺炎(acute pancreatitis, AP)患者预后预测价值.方法计算机检索Medline、EMBASE、Cochrane图书馆、CBM网络版和CNKI等数据库,收集D-二聚体水平升高对AP患者预后影响的临床研究,对符合纳入标准的研究进行质量评价和资料提取后,采用MetaD isc软件进行Meta分析.结果共纳入8项关于D-二聚体对AP患者预后的研究.Meta分析结果显示:D-二聚体对于AP患者严重程度的预测价值合并的敏感度为0.80(95%CI:0.74-0.80),特异度为0.75(95%CI:0.72-0.79),阳性似然比为3.17(95%CI:2.74-3.66),阴性似然比为0.30(95%CI:0.23-0.38),合并的受试者工作特征曲线的曲线下面积为0.8345(诊断比值比=11.47; 95%CI:8.06-16.33),且无显著的异质性(Q=4.57, I2=0.0%, P>0.1).结论 D-二聚体水平升高有助于早期鉴别不同严重程度的AP患者.

AIM To investigate the prognostic value of D-dimer in patients with acute pancreatitis(AP).METHODS Medline,EMbase,Cochrane library,CBM,CNKI and other resources(from the date of their establishment to October 2017)were searched systematically.Eligible cohort studies on the predictive value of D-dimer in AP patients were collected.Quality assessment and data extraction were performed in those clinical trials in line with the inclusion criteria.Meta Disc software was applied to carry out meta-analysis.RESULTS Eight studies were included in the quantitative analysis.The pooled sensitivity,specificity,positive likelihood ratio,and negative likelihood ratio with corresponding 95%CI for prediction of severity of AP were 0.80(0.74-0.80),0.75(0.72-0.79),3.17(2.74-3.66),and 0.30(0.23-0.38),respectively.The area under the receiver operating characteristic curve was 0.8345(diagnostic odds ratio=11.47;95%CI:8.06-16.33),albeit with no significant heterogeneity(Q=4.57,I2=0.0%,P>0.1).CONCLUSION D-dimer has the potential to serve as a prognostic marker on admission for differentiating disease severity of AP.