中性粒细胞 CD64 联合 CRP 对新生儿败血症的诊断价值：Meta 分析。

Diagnostic value of neutrophil CD64 combined with CRP for neonatal sepsis: A meta-analysis.

机构信息

Department of Pediatrics, Fuling Central Hospital of Chongqing City, Chongqing 408000, China.

出版信息

Am J Emerg Med. 2019 Aug;37(8):1571-1576. doi: 10.1016/j.ajem.2019.05.001. Epub 2019 May 3.

DOI:10.1016/j.ajem.2019.05.001

PMID:31085013

Abstract

BACKGROUND

Sepsis is the leading cause of morbidity and mortality in newborns. CD64 combined with c-reactive protein (CRP) could improve the sensitivity and specificity of neonatal sepsis diagnosis, but the results were still controversial. Therefore, this meta-analysis was conducted to clarify the importance of CD64 combined with CRP in the diagnosis of neonatal sepsis.

METHODS

The researches published as of December 24, 2018 were comprehensively searched in PubMed, Embase (included Embase and Medline), the Cochrane Library and Web of Science. Totally, 8 articles were included, involving 1114 objects. Statistical calculations were performed using Stata14.0 and Review Manager 5.3.

RESULTS

The diagnostic accuracy of all included studies was pooled as follows: sensitivity, 0.95 (95% CI: 0.86-0.98); specificity, 0.86 (95% CI: 0.74-0.93); positive likelihood ratio (PLR), 6.8 (95% CI: 3.50-13.20); negative likelihood ratio (NLR), 0.06 (95% CI: 0.02-0.18); diagnostic odds ratio (DOR), 118.0 (95% CI: 25.00-549.00), and the area under the curve (AUC) was 0.96 (95% CI: 0.94-0.97). It was found that heterogeneity was not caused by threshold effect (P = 0.16), but the results of sensitivity (I = 87.57%) and specificity (I = 89.07%) analyses indicated significant heterogeneity between studies.

CONCLUSIONS

The combined application of CD64 and CRP improved the accuracy of neonatal sepsis diagnosis.

摘要

背景

败血症是新生儿发病率和死亡率的主要原因。CD64 联合 C 反应蛋白（CRP）可提高新生儿败血症诊断的灵敏度和特异性，但结果仍存在争议。因此，进行了这项荟萃分析以阐明 CD64 联合 CRP 在新生儿败血症诊断中的重要性。

方法

全面检索了截至 2018 年 12 月 24 日在 PubMed、Embase（包括 Embase 和 Medline）、Cochrane 图书馆和 Web of Science 上发表的研究。共纳入 8 项研究，涉及 1114 例患者。使用 Stata14.0 和 Review Manager 5.3 进行统计计算。

结果

所有纳入研究的诊断准确性汇总如下：灵敏度为 0.95（95%CI：0.86-0.98）；特异度为 0.86（95%CI：0.74-0.93）；阳性似然比（PLR）为 6.8（95%CI：3.50-13.20）；阴性似然比（NLR）为 0.06（95%CI：0.02-0.18）；诊断比值比（DOR）为 118.0（95%CI：25.00-549.00），曲线下面积（AUC）为 0.96（95%CI：0.94-0.97）。结果发现，异质性不是由阈值效应引起的（P=0.16），但敏感性（I=87.57%）和特异性（I=89.07%）分析结果表明研究之间存在显著的异质性。