1 血浆可溶性髓细胞触发受体-1 对脓毒症诊断价值的系统评价.pdfVIP

• 论  著  二次研究 2013, 13(4): 425 430 中国循证医学杂志 ～ 血浆可溶性髓细胞触发受体-1对脓毒症 诊断价值的系统评价 吴友平  李金宝  邓小明* 第二军医大学第一附属长海医院麻醉科（上海 200433 ） 摘要  目的 系统评价血浆可溶性髓细胞触发受体-1 （sTREM-1 ）在脓毒症早期诊断中的价值。方法 计算 机检索Cochrane 图书馆（2012 年第4 期）、PubMed、EMbase 、CBM、CNKI 、VIP 和WanFang Data ，收集有关血浆 sTREM-1 诊断脓毒症的诊断性试验，检索时限截至2012 年4 月 。由2 位评价者根据纳入与排除标准独立筛选文 献、提取资料和评价质量后，采用Meta-Disc 1.5 软件进行分析，并绘制汇总受试者工作特征（SROC ）曲线、计算曲 线下面积和Q* 指数。结果 最终纳入 11 个研究，共 1 615 例患者。结果显示：敏感性为69% ，特异性为71% ，阳 性似然比为3.7 ，阴性似然比为0.34 ，诊断比值比为14.73，SROC 曲线下面积为0.875 ，Q* 指数为0.805 。结论 血 浆sTREM-1 作为单独指标对脓毒症的早期诊断准确性为中等。临床上尚需联合其他诊断指标，以进一步提高诊断 的敏感性和特异性。 关键词 脓毒症；血浆可溶性髓细胞触发受体-1 ；诊断性试验；系统评价 Diagnostic Value of Plasma Soluble Triggering Receptor Expressed on Myeloid Cells-1 for Sepsis: A Systematic Review WU You-ping, LI Jin-bao, DENG Xiao-ming* Department of Anesthesiology, Changhai Hospital, The First Affiliated Hospital, The Second Military Medical University, Shanghai 200433, China Abstract Objective To evaluate the diagnostic value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for sepsis. Methods Such databases as The Cochrane Library (Issue 4, 2012), PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched to collect the diagnostic tests on sTREM-1 for sepsis published before April 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. Then, Meta-Disc software (Version 1.5) was used to conduct analyses, draw the sum- mary receiver operating characteristic (SROC) curve, and calculate the area under curve and Q* index. Results A total of 11 studies involving 1 615 patients were included. The value of sensitivity, specificity, positive likelihoo