微小核糖核酸作为急性脑梗死诊断标志物的Meta分析

A meta-analysis of miRNAs as novel biomarkers for the diagnosis of acute cerebral infarction

目的:通过Meta分析方法,分析miRNA作为急性脑梗死诊断标志物的价值。方法:检索Medline、PubMed、Embase、Cochrane Library Database、万方数据库、中国学术期刊网全文数据库(CNKI)和维普数据库(VIP)相关文献,检索时间从建库至2018年12月。纳入的研究通过诊断准确性研究质量评价工具(QUADAS)进行质量评价,并采用Stata 14和Meta-Disc 1.4进行Meta分析,采用随机效应模型合并分析灵敏度(SEN)、特异度(SPE)、阳性似然比(PLR)、阴性似然比(NLR)和诊断比势比(DOR)。通过受试者工作特征(ROC)曲线和曲线下面积(AUC)估计整体检验效能。结果:最终共纳入19个研究,包含急性脑梗死患者1543例,对照组1037例。整体miRNA诊断急性脑梗死的SEN、SPE分别为0.82(95%CI:0.80~0.83)、0.81(95%CI:0.79~0.83),PLR为5.19(95%CI:3.61~7.47),NLR是0.24(95%CI:0.20~0.30),DOR为24.01(95%CI:14.92~38.64)。SROC曲线的AUC为0.89。结论:在诊断急性期脑梗死方面,miRNA具有较高的灵敏度,是较好的诊断标志物。

Objective:To summarize the overall diagnostic assessment of miRNAs for Acute Cerebral Infarction by Meta analysis.Methods:Medline,PubMed,Embase,Cochrane Library Database,Wan Fang,CNKI and VIP Database were searched for this study from inception to December 2018.The quality of included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies(QUADAS)checklist and Stata 14 and meta-disc 1.4 were used for Meta analysis.The pooled sensitivity,specificity,positive likelihood ratio and negative LR were analyzed using random effect model.The overall test efficacy was estimated using the summary receiver operating characteristic(ROC)curve and the area under the curve(AUC).Results:A total of19 studies involving 1543 patients with Acute Cerebral Infarction and 1037 controls were finally included.For overall miRNA,the pooled sensitivity,specificity,positive LR and negative LR,diagnosis odds ratio(DOR)to predict Acute Cerebral Infarction patients were 0.82(95%CI:0.80-0.83),0.81(95%CI:0.79-0.83),5.19(95%CI:3.61-7.47),0.24(95%CI:0.20-0.30),24.01(95%CI:14.92-38.64),respectively,corresponding to an AUC of 0.89.Conclusions:miRNA have high diagnostic value for acute cerebral infarction,and their expressions can be used as novel biomarkers in confirming acute cerebral infarction.