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血清、血浆和尿液中性粒细胞明胶酶相关脂质运载蛋白对脓毒症患者急性肾损伤诊断价值的Meta分析

Meta-analysis of the diagnostic value of serum, plasma and urine neutrophil gelatinase-associated lipocalin for the detection of acute kidney injury in patients with sepsis.

作者信息

Zhou Hong, Cui Juan, Lu You, Sun Jing, Liu Jianzhou

机构信息

Department of Emergency, Emergency General Hospital, Chaoyang, Beijing 100028, P.R. China.

Department of Pharmacy, Emergency General Hospital, Chaoyang, Beijing 100028, P.R. China.

出版信息

Exp Ther Med. 2021 Apr;21(4):386. doi: 10.3892/etm.2021.9817. Epub 2021 Feb 23.

Abstract

The objective of the present study was to assess the diagnostic value of urine, serum and plasma neutrophil gelatinase-associated lipocalin (NGAL) for the early diagnosis of acute kidney injury (AKI) among patients with suspected sepsis. Therefore, a meta-analysis was carried out to evaluate diagnostic accuracy data from the literature regarding the diagnosis of AKI in patients with sepsis. Electronic databases were systematically searched for relevant studies and quality assessment was conducted using the Quality Assessment for Diagnostic Accuracy Studies 2 tool. A summary receiver operating characteristic curve analysis was performed, and several parameters including sensitivity, specificity, diagnosis odds ratio (DOR) and area under the curve (AUC) were calculated to evaluate the diagnostic performance of urine, serum and plasma NGAL. Meta-regression, sensitivity and subgroup analysis were also conducted to identify the source of heterogeneity in the eligible studies. In total, 28 studies were included. The pooled sensitivities for urine, serum and plasma NGAL were 0.87, 0.83 and 0.80, respectively. Pooled specificity was 0.84, 0.79 and 0.74. The DORs were 35, 18 and 11, respectively. The AUC for urine, serum and plasma NGAL were 0.92, 0.87 and 0.84, respectively. Urine NGAL presented superior performance for the diagnosis of AKI with the highest AUC and other diagnostic accuracy values, compared with serum and plasma NGAL. Further studies are needed to clarify the controversial issue between the usefulness of serum and plasma NGAL.

摘要

本研究的目的是评估尿液、血清和血浆中性粒细胞明胶酶相关脂质运载蛋白(NGAL)对疑似脓毒症患者急性肾损伤(AKI)早期诊断的价值。因此,进行了一项荟萃分析,以评估文献中关于脓毒症患者AKI诊断的诊断准确性数据。系统检索电子数据库以查找相关研究,并使用诊断准确性研究质量评估2工具进行质量评估。进行了汇总受试者工作特征曲线分析,并计算了包括敏感性、特异性、诊断比值比(DOR)和曲线下面积(AUC)在内的几个参数,以评估尿液、血清和血浆NGAL的诊断性能。还进行了荟萃回归、敏感性和亚组分析,以确定符合条件的研究中的异质性来源。总共纳入了28项研究。尿液、血清和血浆NGAL的合并敏感性分别为0.87、0.83和0.80。合并特异性分别为0.84、0.79和0.74。DOR分别为35、18和11。尿液、血清和血浆NGAL的AUC分别为0.92、0.87和0.84。与血清和血浆NGAL相比,尿液NGAL在诊断AKI方面表现出更好的性能,具有最高的AUC和其他诊断准确性值。需要进一步的研究来阐明血清和血浆NGAL有用性之间的争议问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e7e/7918111/31d7fc66e2e0/etm-21-04-09817-g00.jpg

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