血清生物学指标诊断急性肠系膜缺血系统评价

Serologic biomarkers for acute mesenteric ischemic:a systematic review

目的评估经典标志物、新型血清学生物标志物及其他标志物对急性肠系膜缺血(acute mesenteric ischemia,AMI)的诊断效果。方法计算机检索PubMed及Embase,搜集评估AMI血清学标志物的研究,检索时间为自建库至2020年8月15日,对纳入的研究进行定性归纳。结果共纳入28篇研究,包括5篇Meta分析、7篇前瞻性研究、8篇回顾性研究、4篇横断面研究和4篇动物实验。经典标志物(L-乳酸、D-乳酸和乳酸脱氢酶)的特异度和敏感度均较低,新型血清学生物标志物(D-二聚体、血小板指数、中性粒细胞-淋巴细胞比率、缺血修饰白蛋白、I-脂肪酸结合蛋白、α-谷胱甘肽s-转移酶、瓜氨酸)与其他标志物在一定程度上可提高AMI的诊断准确性,但诊断价值较为有限。结论 AMI血清学生物标志物诊断价值较为有限,尚难以对不同类型和阶段的AMI进行诊断,仍需开展高质量、大样本的研究予以证实。

Objective To evaluate the effects of classical markers,novel serological biomarkers and other markers on the diagnosis of acute mesenteric ischemia(AMI).Methods PubMed and Embase were searched by computer to collect and evaluate the studies on serum markers of AMI from the establishment of the database to August 15,2020.Qualitative induction was conducted for the included studies.Results A total of 28 studies,including 5 meta-analysis,7 prospective studies,8 retrospective studies,4 cross-sectional studies and 4 animal studies,were included.The speciality and sensitivity of classic markers(L-lactic acid,D-lactic acid and LDH)were low.The new serological biomarkers(D-dimer,platelet index,neutrophil-lymphocyte ratio,ischemia modifies albumin,1-fatty acid binding protein,a-glutathione s-transferase,citruline)and other markers of AMI can be improved to some extent,but the diagnostic value is still relatively limited.Conclusion The diagnostic value of serum biomarkers of AMI is limited,and it is still difficult for those markers to be used to diagnose AMI in different types and stages.High-quality and large-sample studies are still needed to confirm it.