降钙素原对腹部手术后早期腹腔感染诊断价值的meta分析

Meta-analysis of the diagnostic value of procalcitonin in early abdominal infection after abdominal surgery

目的采用荟萃分析的方法评价血清降钙素原在诊断腹部手术后早期腹腔感染的诊断价值。方法通过计算机检索中国知网、维普、万方、中国生物医学文献服务系统、PubMed、Springer等数据库,并通过追查参考文献、手工检索的方法搜索2001年1月至2023年1月发表的关于降钙素原和腹腔感染相关的文献,凭借纳入和排除标准筛选文献,提取数据和评价文献质量后,采用RevMan 5.3软件、Meta Disc 1.4软件进行数据分析。结果共纳入13篇文献,共计2021个病例,其中腹腔感染组487例,对照组1535例,meta分析显示降钙素原诊断手术后腹腔感染的敏感度为75%[95%CI(71%~79%)],特异度为66%[95%CI(64%~68%)],阳性似然比为3.20[95%CI(2.26~4.54)],阴性似然比为0.35[95%CI(0.26~0.46)],SROC的AUC为0.8348。结论降钙素原诊断术后腹腔感染的效能较高,能较好地早期发现腹腔感染,有望成为早期预测腹腔感染的独立指标。

Objective The diagnostic value of serum procalcitonin in the early abdominal infection after abdominal surgery was evaluated by meta-analysis.Methods CNKI,VIP,Wanfang,SinoMed,PubMed,Springer and other databases were searched by computer.The literatures on procalcitonin and abdominal infection published from January 2001 to January 2023 were searched by reference tracing and manual retrieval.References were screened according to inclusion and exclusion criteria,and after data extraction and literature quality evaluation,data analysis was performed using RevMan 5.3 software and Meta Disc 1.4 software.Results A total of 2021 cases were included in 13 literatures,including 487 cases in the abdominal infection group and 1535 cases in the control group.The meta-analysis showed that the sensitivity and specificity of procalcitonin in the diagnosis of postoperative abdominal infection were 75%[95%CI(71%-79%)]and 66%[95%CI(64%-68%)].The positive likelihood ratio was 3.20[95%CI(2.26-4.54)],the negative likelihood ratio was 0.35[95%CI(0.26-0.46)],and the AUC of SROC was 0.8348.Conclusion Procalcitonin is effective in the diagnosis of postoperative abdominal infection,and can be used as an independent index for early prediction of abdominal infection.