Neutrophil CD64 expression as a diagnostic marker for sepsis in adult patients: a meta-analysis
Neutrophil CD64 expression as a diagnostic marker for sepsis in adult patients: a meta-analysis
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中性粒细胞 CD64 表达作为成年患者脓毒症的诊断标志物：荟萃分析
DOI：
10.1186/s13054-015-0972-z
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发表时间：
2015-06-10
期刊：
影响因子：
15.1
通讯作者：
Jiang, Jian-Xin
中科院分区：
文献类型：
--
作者：
Wang, Xiao;Li, Zhong-Yun;Jiang, Jian-Xin
前言中性粒细胞CD64(NCD64)的表达是细菌感染的一个有前景的标志物。这项荟萃分析的目的是评估nCD64表达对重症成人患者脓毒症诊断的准确性。方法我们系统地搜索了PubMed、Embase、ISI Web of Knowledge和Cochrane图书馆在数据库建立至2014年5月19日期间发表的文献，以及已确定的主要研究的参考列表。如果这些研究包括对nCD64表达对成人患者脓毒症诊断的准确性的评估，并提供足够的信息来构建2×2列联表，则纳入研究。结果共有8项研究，包括1986名患者，符合最终分析的纳入标准。合并敏感度和特异度分别为0.76(95%可信区间0.73~0.78)和0.85(95%可信区间0.82~0.87)。阳性似然比为8.15(95%CI，3.82~17.36)，阴性似然比为0.16(95%CI，0.09~0.30)，诊断优势比为60.41(95%CI，15.87~229.90)。NCD64表达与Q*值的受试者工作特征曲线下面积为0.95(Q*=0.89)。结论在荟萃分析的基础上，nCD64表达可作为危重病患者脓毒症的早期诊断指标。不应单独使用测试结果来诊断脓毒症，而应结合病史、体检和其他测试结果进行解释。
IntroductionNeutrophil CD64 (nCD64) expression appears to be a promising marker of bacterial infections. The aim of this meta-analysis was to assess the accuracy of nCD64 expression for the diagnosis of sepsis in critically ill adult patients.MethodsWe systematically searched PubMed, Embase, ISI Web of Knowledge, and the Cochrane Library for literature published between database inception and 19 May 2014, as well as reference lists of identified primary studies. Studies were included if they included assessment of the accuracy of nCD64 expression for sepsis diagnosis in adult patients and provided sufficient information to construct a 2×2 contingency table.ResultsA total of 8 studies comprising 1986 patients fulfilled the inclusion criteria for the final analysis. The pooled sensitivity and specificity were 0.76 (95 % confidence interval [CI], 0.73–0.78) and 0.85 (95 % CI, 0.82–0.87), respectively. The positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 8.15 (95 % CI, 3.82–17.36), 0.16 (95 % CI, 0.09–0.30), and 60.41 (95 % CI, 15.87–229.90), respectively. The area under the summary receiver operating characteristic curve of nCD64 expression with Q* value were 0.95 (Q* =0.89).ConclusionsOn the basis of our meta-analysis, nCD64 expression is a helpful marker for early diagnosis of sepsis in critically ill patients. The results of the test should not be used alone to diagnose sepsis, but instead should be interpreted in combination with medical history, physical examination, and other test results.