生物标志物在诊断糖尿病足骨髓炎中的作用。一项荟萃分析。
The Role of Biomarkers to Diagnose Diabetic Foot Osteomyelitis. A Meta-analysis.
作者信息
Victoria van Asten Suzanne Aura, Geradus Peters Edgar Joseph, Xi Yin, Lavery Lawrence Alfred
机构信息
Department of Plastic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Texas, USA.
出版信息
Curr Diabetes Rev. 2016;12(4):396-402. doi: 10.2174/1573399811666150713104401.
PURPOSE
To systematically review the value of serum inflammatory markers to diagnose diabetic foot osteomyelitis (DFO).
STUDY SELECTION
Studies to diagnose DFO using biomarkers erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), interleukins (IL-2, IL-6, IL-8) and tumor necrosis factor alfa (TNF.) were retrieved from EMBASE and PubMed with no language restrictions through July 2014.
DATA EXTRACTION
We summarized clinical characteristics of the studies and used bivariate random effects models and summary receiver operating characteristic curves to estimate sensitivity and specificity for each marker.
DATA SYNTHESIS
A total of 8 qualifying studies were included in our meta-analysis. Bivariate pooled sensitivity and specificity of the 6 studies examining ESR were 0.81 (95% CI 0.71-0.88) and 0.90 (95% CI 0.75-0.96) respectively. Due to the paucity of data, models did not converge for the other biomarkers.
CONCLUSIONS
From the inflammatory markers, ESR appears to be the best laboratory test to identify patients with DFO.
目的
系统评价血清炎症标志物对糖尿病足骨髓炎（DFO）的诊断价值。
研究选择
通过检索EMBASE和PubMed，获取截至2014年7月的、使用生物标志物红细胞沉降率（ESR）、C反应蛋白（CRP）、降钙素原（PCT）、白细胞介素（IL-2、IL-6、IL-8）和肿瘤坏死因子α（TNF-α）诊断DFO的研究，无语言限制。
数据提取
我们总结了研究的临床特征，并使用双变量随机效应模型和汇总受试者工作特征曲线来估计每个标志物的敏感性和特异性。
数据合成
我们的荟萃分析共纳入8项合格研究。6项检测ESR的研究的双变量合并敏感性和特异性分别为0.81（95%CI 0.71-0.88）和0.90（95%CI 0.75-0.96）。由于数据匮乏，其他生物标志物的模型未收敛。
结论
在炎症标志物中，ESR似乎是识别DFO患者的最佳实验室检查。
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