Diagnostic Accuracy of Procalcitonin in Bacterial Meningitis Versus Nonbacterial Meningitis: A Systematic Review and Meta-Analysis.
Diagnostic Accuracy of Procalcitonin in Bacterial Meningitis Versus Nonbacterial Meningitis: A Systematic Review and Meta-Analysis.
复制标题
降钙素原对细菌性脑膜炎与非细菌性脑膜炎的诊断准确性系统评价和荟萃分析
DOI：
10.1097/md.0000000000003079
复制
发表时间：
2016-03
期刊：
影响因子：
1.6
通讯作者：
Zhong RQ
中科院分区：
文献类型：
--
作者：
Wei TT;Hu ZD;Qin BD;Ma N;Tang QQ;Wang LL;Zhou L;Zhong RQ
几项研究调查了血液或脑脊液（CSF）中降钙素原（PCT）水平对细菌性脑膜炎（BM）诊断的准确性，但结果不一致。本研究的目的是确定PCT作为BM检测标志物的诊断准确性。对EMBASE、Scopus、Web of Science和PubMed数据库进行了系统检索，以识别2015年12月7日之前发表的研究，研究PCT对BM的诊断准确性。使用修订的诊断准确性研究质量评估方法评估合格研究的质量。使用双变量模型汇总CSF或血液中PCT检测的总体诊断准确性。本系统性综述和荟萃分析纳入了22项研究，涉及2058例受试者。CSF PCT的总体特异性和敏感性分别为0.86和0.80，血液PCT的总体特异性和敏感性分别为0.97和0.95。CSF PCT和血液PCT的汇总受试者工作特征曲线下面积分别为0.90和0.98。本系统性综述和荟萃分析的主要局限性在于纳入的研究数量较少，且合格研究采用的诊断阈值具有异质性。我们的荟萃分析显示PCT是BM诊断的有用生物标志物。
Several studies have investigated the diagnostic accuracy of procalcitonin (PCT) levels in blood or cerebrospinal fluid (CSF) in bacterial meningitis (BM), but the results were heterogeneous. The aim of the present study was to ascertain the diagnostic accuracy of PCT as a marker for BM detection. A systematic search of the EMBASE, Scopus, Web of Science, and PubMed databases was performed to identify studies published before December 7, 2015 investigating the diagnostic accuracy of PCT for BM. The quality of the eligible studies was assessed using the revised Quality Assessment for Studies of Diagnostic Accuracy method. The overall diagnostic accuracy of PCT detection in CSF or blood was pooled using the bivariate model. Twenty-two studies involving 2058 subjects were included in this systematic review and meta-analysis. The overall specificities and sensitivities were 0.86 and 0.80 for CSF PCT, and 0.97 and 0.95 for blood PCT, respectively. Areas under the summary receiver operating characteristic curves were 0.90 and 0.98 for CSF PCT and blood PCT, respectively. The major limitation of this systematic review and meta-analysis was the small number of studies included and the heterogeneous diagnostic thresholds adopted by eligible studies. Our meta-analysis shows that PCT is a useful biomarker for BM diagnosis.