尿酸对子痫前期诊断价值的meta分析

Diagnostic value of uric acid level for preeclampsia:a meta-analysis

目的:系统评价尿酸在子痫前期诊断中的临床价值。方法:检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学文献数据库(CBM)、PubMed、EMBASE、Cochrane图书馆、临床注册中心等数据库,时限为建库至2010年7月的相关文献。按照纳入排除标准对原始文献进行筛选、数据提取、质量评价。结果:10篇文献纳入研究,合并的敏感度、特异度、阳性似然比、阴性似然比、诊断比值比分别为0.72(95%CI 0.690.74)、0.61(95%CI 0.600.62)、3.28(95%CI 1.985.48)、0.33(95%CI 0.210.51)、10.36(95%CI 5.1021.05);SROC曲线下面积为0.8380;meta回归表明,样本量及截断值是异质性的主要原因;Deek漏斗图提示发表偏倚无统计学意义;Fagan图显示验前概率为50%,验后概率为94%。结论:尿酸对子痫前期的诊断效能较高,但特异度稍差。需更多大样本、前瞻性研究进一步证实。

Objective: To evaluate the diagnostic value of uric acid level for preeclampsia. Methods: The relevant literatures in the databases up to July 2020, such as Chinese national knowledge infrastructure(CNKI), Wanfang, VIP, China biomedical literature database, PubMed, Embase, Cochrane Library, Clinical registry and systematically, were searched. According to the inclusion and exclusion criteria, the original literatures were screened, the quality of the literatures was evaluated, and the data were extracted from the literatures. Results: There were 10 literatures included in this meta-analysis. The pooled sensitivity, specificity, positive and negative likelihood ratio, and diagnostic odds ratio were 0.72(95%CI: 0.69-0.74), 0.61(95%CI: 0.60-0.62), 3.28(95%CI: 1.98-5.48), 0.33(95%CI: 0.21-0.51), and 10.36(95%CI: 5.10-21.05), respectively. Area under the curve was 0.8380. Meta-regression analysis showed that sample size and cutoff value were the main sources of heterogeneity. There was no statistical significance for the evaluation of publication bias by Deek funnel plot. Fagan graphs showed that the pre-test probability was 50%, and the post-test probability was 94%. Conclusion: Uric acid level has higher diagnostic efficiency for preeclampsia, but its specificity is slightly poor, which should be further confirmed by more prospective researches with large samples.