中性粒细胞CD64作为新生儿败血症的诊断标志物：荟萃分析。
Neutrophil CD64 as a diagnostic marker for neonatal sepsis: Meta-analysis.
作者信息
Dai Ji, Jiang Wenjie, Min Zhigang, Yang Jian, Tan Yongfei, Ma Tieliang, Ge Zhijun
机构信息
Department of Critical Care Medicine, the Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China.
Department of Anesthesiology, the Affiliated Yixing Hospital of Jiangsu University, Yixing, Jiangsu, China.
出版信息
Adv Clin Exp Med. 2017 Mar-Apr;26(2):327-332. doi: 10.17219/acem/58782.
BACKGROUND
Neutrophil CD64 (nCD64) is a promising marker for diagnosing bacterial infections. Several studies have investigated the performance of nCD64 for diagnosing neonatal sepsis and the results are variable. Interest in nCD64 for detecting serious bacterial infections is increasing rapidly.
OBJECTIVES
The aim of the present study was to carry out a meta-analysis to systematically evaluate the diagnostic accuracy of nCD64 in neonatal sepsis. As far as the authors know, no previous studies have undertaken this.
MATERIAL AND METHODS
A review of studies from Pubmed, Embase and the Cochrane Library, from inception through June 2015, found 7 studies (involving 2213 neonates) fulfilling the inclusion criteria. These 7 studies were subjected to a bivariate meta-analysis of sensitivity and specificity and a summary receiveroperating characteristic (SROC) curve; I2 was used to test heterogeneity, and the source of heterogeneity was investigated by influence analysis and meta-regression.
RESULTS
The pooled sensitivity and specificity were 80% (95%CI, 69-88%) and 83% (95%CI, 71-90%), respectively. The area under the SROC curve (AUC) was 0.88 (95%CI, 0.85-0.91). The studies had substantial heterogeneity (I2 = 87.1%).
CONCLUSIONS
The results showed that nCD64 is a reliable biomarker for diagnosing neonatal sepsis (AUC = 0.88).
背景
中性粒细胞CD64（nCD64）是诊断细菌感染的一个有前景的标志物。多项研究调查了nCD64在诊断新生儿败血症方面的性能，结果存在差异。对nCD64用于检测严重细菌感染的兴趣正在迅速增加。
目的
本研究的目的是进行一项荟萃分析，以系统评估nCD64在新生儿败血症诊断中的准确性。据作者所知，之前尚无研究进行过此项分析。
材料与方法
对PubMed、Embase和Cochrane图书馆自创建至2015年6月的研究进行回顾，发现7项研究（涉及2213例新生儿）符合纳入标准。对这7项研究进行敏感性和特异性的双变量荟萃分析以及汇总的受试者工作特征（SROC）曲线分析；使用I²检验异质性，并通过影响分析和荟萃回归研究异质性的来源。
结果
合并敏感性和特异性分别为80%（95%CI，69 - 88%）和83%（95%CI，71 - 90%）。SROC曲线下面积（AUC）为0.88（95%CI，0.85 - 0.91）。这些研究存在显著异质性（I² = 87.1%）。
结论
结果表明，nCD64是诊断新生儿败血症的可靠生物标志物（AUC = 0.88）。
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