Sun Da-Li, Li Shu-Min, Cen Yun-Yun, Xu Qing-Wen, Li Yi-Jun, Sun Yan-Bo, Qi Yu-Xing, Lin Yue-Ying, Yang Ting, An Li-Ya, Su Kun, Li Wei-Ming, Xu Peng-Yuan
Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University Research Center for Surgical Clinical Nutrition, Kunming Professor Yang Hua Research Station, Yunnan Province, China.
Medicine (Baltimore). 2017 Mar;96(13):e6380. doi: 10.1097/MD.0000000000006380.
The purpose of this meta-analysis is to comprehensively assess the accuracy of serum D-dimer for the diagnosis of acute intestinal ischemia.
Diagnostic studies of D-dimer for accurate diagnosis of acute intestinal ischemia were extracted from 6 databases, and prospective and retrospective studies that provided adequate data on sensitivity and specificity were included here. Sensitivity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated. The overall diagnostic performance of D-dimer was assessed by plotting a summary receiver operating characteristic curve (SROC) and calculating the area under the curve (AUC).
A total of 1300 patients with suspected acute intestinal ischemia from 12 studies met the inclusion criteria. The combined sensitivity, specificity, PLR, NLR, and DOR were 0.94 (95% CI: 0.87-0.97), 0.50 (95% CI: 0.40-0.61), 1.9 (95% CI: 1.5-2.3), 0.12 (95% CI: 0.05-0.26), and 16 (95% CI: 7-39), respectively. The AUC was 0.81 (95% CI: 0.78-0.84).
The results of this meta-analysis suggested that plasma D-dimer detection might be a useful means of identifying patients with acute intestinal ischemia of the abdomen.
本荟萃分析的目的是全面评估血清D-二聚体对急性肠缺血诊断的准确性。
从6个数据库中提取关于D-二聚体准确诊断急性肠缺血的诊断性研究,纳入提供了足够敏感性和特异性数据的前瞻性和回顾性研究。计算敏感性、阳性似然比(PLR)、阴性似然比(NLR)和诊断比值比(DOR)。通过绘制汇总受试者工作特征曲线(SROC)并计算曲线下面积(AUC)来评估D-二聚体的总体诊断性能。
12项研究中共有1300例疑似急性肠缺血患者符合纳入标准。合并的敏感性、特异性、PLR、NLR和DOR分别为0.94(95%CI:0.87-0.97)、0.50(95%CI:0.40-0.61)、1.9(95%CI:1.5-2.3)、0.12(95%CI:0.05-0.26)和16(95%CI:7-39)。AUC为0.81(95%CI:0.78-0.84)。
本荟萃分析结果表明,血浆D-二聚体检测可能是识别腹部急性肠缺血患者的一种有用方法。