血清淀粉样蛋白A对成人脓毒症诊断价值的Meta分析

Meta analysis of the diagnostic value of serum amyloid A in the adults with sepsis

目的系统评价血清淀粉样蛋白A(serum amyloid A,SAA)对成人脓毒症诊断的准确性。方法通过计算机检索知网、维普、万方、Sinomed、PubMed、Embase、Cochrane图书馆等公开发表的有关文献,通过QUADAS量表对纳入文献进行质量评估。采用Metadisc1.4和Stata12.0进行异质性分析,根据异质性结果选择效应模型进行定量合成;为减小异质性和阈值的影响,综合灵敏度和特异度的信息,以受试者工作特征曲线(SROC)、曲线下面积(AUC)及Q*指数进行综合评价。结果最终有13篇文献纳入Meta分析,结果显示,SAA对成人脓毒症诊断敏感度为0.72(95%CI 0.70~0.75)和特异度为0.69(95%CI 0.66~0.71),SROC的AUC为0.78,Q*指数为0.72。结论SAA对成人脓毒症诊断的敏感度和特异度较高,可为诊断成人脓毒症提供依据。

Objective To systematically evaluate the diagnostic accuracy of serum amyloid A(SAA)in the adults with sepsis.Methods The literatures published in CNKI,VIP,Wanfang,Sinomed,PubMed,Embase and Cochrane library were searched by computer.QUADAS scale was used to evaluate the quality of the included literatures.Metaisc1.4 and Stata12.0 were used for heterogeneity analysis,and effect models were selected for quantitative synthesis according to the heterogeneity results.In order to reduce the influence of heterogeneity and threshold,the information of sensitivity and specificity were integrated,and the summary receiver operating characteristic curve(SROC),the area under the curve(AUC)and Q*index were used for comprehensive evaluation.Results Thirteen studies were included in the Meta analysis.The results showed that the sensitivity and specificity of SAA for the diagnosis of adult sepsis were 0.72(95%CI 0.70-0.75)and 0.69(95%CI 0.66-0.71).The AUC and Q*index of SROC were 0.78 and 0.72.Conclusions SAA has good sensitivity and specificity in the diagnosis of adult sepsis,which can provide a basis for the diagnosis of adult sepsis.