与血清肌酐相比，胱抑素C在评估成人和儿童肾功能不全中的诊断准确性——一项荟萃分析。
Diagnostic accuracy of cystatin C compared to serum creatinine for the estimation of renal dysfunction in adults and children--a meta-analysis.
作者信息
Roos Juliana F, Doust Jenny, Tett Susan E, Kirkpatrick Carl M J
机构信息
School of Pharmacy, University of Queensland, Brisbane, QLD 4072, Australia.
出版信息
Clin Biochem. 2007 Mar;40(5-6):383-91. doi: 10.1016/j.clinbiochem.2006.10.026. Epub 2007 Jan 5.
OBJECTIVES
To perform a systematic review comparing the diagnostic accuracy of CysC with SCr.
METHODS
MEDLINE and EMBASE (January 1984-February 2006) were searched. Studies included i) evaluated CysC against a recognised 'gold standard' method for determining GFR using a receiver operating characteristics (ROC) curve analysis and ii) included data that could be extracted into a 2x2 table.
RESULTS
The search identified 27 population groups in 24 studies (n=2007) that compared the diagnostic accuracy of CysC with SCr. The diagnostic odds ratios (DORs) (95% CI) of predicting renal dysfunction derived from a Moses-Littenberg linear regression model were 3.99 (3.41-4.57) for CysC and 2.79 (2.12-3.46) for SCr.
CONCLUSION
The diagnostic accuracy for impaired renal function favours CysC. However, the confidence intervals for the pooled DORs for the biomarkers overlap. The ability of CysC (cut-off values between 0.9 and 1.4 mg/L) to rule in renal impairment (as measured by inulin-determined GFR of 60-79 mL/min/1.73 m2) in persons in whom this is suspected is large and conclusive.
目的
进行一项系统评价，比较胱抑素C（CysC）与血清肌酐（SCr）的诊断准确性。
方法
检索MEDLINE和EMBASE（1984年1月至2006年2月）。纳入的研究包括：i）使用受试者工作特征（ROC）曲线分析，对照公认的测定肾小球滤过率（GFR）的“金标准”方法评估CysC；ii）包含可提取到2×2表格中的数据。
结果
检索确定了24项研究中的27个群体（n = 2007），这些研究比较了CysC与SCr的诊断准确性。根据Moses-Littenberg线性回归模型得出的预测肾功能不全的诊断比值比（DORs）（95%可信区间），CysC为3.99（3.41 - 4.57），SCr为2.79（2.12 - 3.46）。
结论
对于肾功能受损的诊断准确性，CysC更具优势。然而，生物标志物合并DORs的可信区间存在重叠。对于疑似肾功能损害的人群，CysC（临界值在0.9至1.4mg/L之间）诊断肾功能损害（以菊粉测定的GFR为60 - 79mL/min/1.73m²衡量）的能力很强且具有决定性。
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