Cosse Cyril, Sabbagh Charles, Kamel Saïd, Galmiche Antoine, Regimbeau Jean-Marc
Cyril Cosse, Charles Sabbagh, Saïd Kamel, INSERM U1088, Jules Verne University of Picardie, 80054 Amiens, France.
World J Gastroenterol. 2014 Dec 21;20(47):17773-8. doi: 10.3748/wjg.v20.i47.17773.
Intestinal ischemia is common after emergency gastrointestinal or cardiovascular surgery. At present, there are no diagnostic tools for the early diagnosis of intestinal ischemia. In the last decade, procalcitonin (PCT) has been suggested as a marker of this condition. Here, we review the use of PCT as a diagnostic tool for intestinal ischemia. Two reviewers independently searched the PubMed and EMBASE databases for articles on intestinal ischemia and PCT. They then considered (1) the criteria applicable to preclinical and clinical data; and (2) PCT's predictive value in the diagnosis of intestinal ischemia. Article quality was rated according to the STAndards for Reporting of Diagnostic accuracy. Between 1993 and 2014, seven studies (including two preclinical studies and five clinical studies) dealt with the use of PCT to diagnose intestinal ischemia. Procalcitonin's sensitivity, specificity, positive predictive value and negative predictive value ranged between 72% and 100%; 68% and 91%; 27% and 90% and 81% and 100%, respectively. The area under the receiver operating characteristic curve ranged from 0.77 to 0.92. In view of the preclinical and clinical data, we consider that PCT can be used in daily practice as a tool for diagnosing intestinal ischemia.
肠缺血在急诊胃肠或心血管手术后很常见。目前，尚无用于早期诊断肠缺血的诊断工具。在过去十年中，降钙素原（PCT）被认为是这种情况的一个标志物。在此，我们综述了PCT作为肠缺血诊断工具的应用。两名综述作者独立检索了PubMed和EMBASE数据库中关于肠缺血和PCT的文章。然后他们考虑了：（1）适用于临床前和临床数据的标准；以及（2）PCT在肠缺血诊断中的预测价值。根据诊断准确性报告标准对文章质量进行评分。在1993年至2014年期间，有七项研究（包括两项临床前研究和五项临床研究）涉及使用PCT诊断肠缺血。降钙素原的敏感性、特异性、阳性预测值和阴性预测值分别在72%至100%、68%至91%、27%至90%以及81%至100%之间。受试者工作特征曲线下面积在0.77至0.92之间。鉴于临床前和临床数据，我们认为PCT可在日常实践中用作诊断肠缺血的工具。
