红细胞分布宽度对重症急性胰腺炎诊断价值的Meta分析

Diagnostic value of red blood cell distribution width in severe acute pancreatitis:a meta-analysis

目的通过Meta分析方法评估红细胞分布宽度(RDW)对成人急性胰腺炎(AP)严重程度的诊断价值。方法检索中国知网(CNKI)、万方数据、PubMed、Embase、Web of Science,从建库至2021年12月发表的关于RDW诊断、预测急性胰腺炎严重程度或预后的相关研究,不限研究区域。严格遵从纳入、排除标准提取原始文献数据,采用Meta-DiSc14.0软件进行阈值效应分析、效应量合并及Meta分析。结果研究总共检索相关文献384篇,最终19篇纳入研究,涉及研究对象3096例,其中轻症AP 2341例(纳入对照组),重症AP 755例(纳入实验组)。合并后的诊断效应量分别为:敏感度0.74(95%CI:0.70-0.77)、特异度0.78(95%CI:0.76-0.80)、阳性似然比4.04(95%CI:3.02-5.41)、阴性似然比0.27(95%CI:0.19-0.39)、诊断比值比16.98(95%CI:10.92-26.40)和受试者工作曲线下面积0.8772。结论RDW诊断重症胰腺炎具备较好的准确性,可作为临床重症胰腺炎早期诊断预测的简易指标。

Objective To evaluatethe diagnostic value of red blood cell distribution width(RDW)in the severity of adult acute pancreatitis by using meta-analysis.Methods We searched the studies on RDW diagnosis/prediction of severity or prognosis of acute pancreatitis those were published in China national knowledge infrastructure(CNKI),Wanfang Data,PubMed,Embase,and Web of Science science the establishment of database till December 2021,with no limitations on study areas.The original literature data were extracted strictly following the inclusion and exclusion criteria,and Meta-DiSc14.0 software was used for threshold effect analysis,effect size combination,and Meta-analysis.Results A total of 384 related articles were retrieved,and 19 articles were included in the study,involving 3096 subjects,including 2341 mild AP patients(control group)and 755 severe AP patients(experimental group).The combined diagnostic effect sizes were as follows:sensitivity 0.74(95%CI:0.70-0.77),specificity 0.78(95%CI:0.76-0.80),positive likelihood ratio 4.04(95%CI:3.02-5.41),negative likelihood ratio 0.27(95%CI:0.19-0.39),diagnostic odds ratio 16.98(95%CI:10.92-26.40),and areaunder the subject operating curve 0.8772.Conclusions RDW has good accuracy in diagnosing severe pancreatitisand could be used as a simple index for early diagnosis and prediction of severe pancreatitis.