The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China,
Emergency Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
Cerebrovasc Dis. 2021;50(4):365-370. doi: 10.1159/000514382. Epub 2021 Mar 31.
Ischaemia-modified albumin (IMA) is a new, sensitive marker of ischaemic diseases that has been approved for diagnosing myocardial ischaemia. However, the accuracy of IMA in the diagnosis of stroke remains to be clarified. The study's purpose is to assess the potential role of IMA as a diagnostic indicator in stroke.
We carried out a systematic search in Medline, the Cochrane Library, Embase, Scopus, Science Direct, ISI Web of Knowledge, and the reference lists of relevant articles from the databases' inception to September 1, 2019. Studies that appraised the diagnostic accuracy of IMA for acute stroke patients were included in our study. Two reviewers extracted data independently and assessed the quality of the retrieved studies, and disagreements were resolved through discussions with a third reviewer. Sensitivities and specificities were pooled by using bivariate diagnostic meta-analysis. We calculated I2 to test the heterogeneity and used meta-regression to identify potential sources of heterogeneity. This systematic review and meta-analysis is registered in international prospective register of systematic reviews (number CRD42020149174).
Six studies with 605 patients were eligible for inclusion. Our meta-analysis produced the following outcomes: the mean sensitivity of IMA in diagnosing acute stroke was 0.80 (95% confidence interval [CI], 0.69-0.88) and the specificity was 0.80 (95% CI, 0.71-0.87). The area under the receiver operating characteristic curve was 0.86 (95% CI, 0.83-0.89), and the pooled diagnostic odds ratio was 16 (95% CI, 8-33). There was obvious heterogeneity between studies (I2 = 78%, 95% CI, 53-100). Sensitivity analysis and meta-regression could account for the heterogeneity.
IMA is a helpful marker for consideration in the early diagnosis of stroke.
缺血修饰白蛋白（IMA）是一种新的、敏感的缺血性疾病标志物，已被批准用于诊断心肌缺血。然而，IMA 在诊断中风中的准确性仍需阐明。本研究旨在评估 IMA 作为中风诊断指标的潜在作用。
我们在 Medline、Cochrane 图书馆、Embase、Scopus、Science Direct、ISI Web of Knowledge 以及从数据库创建到 2019 年 9 月 1 日的相关文章的参考文献列表中进行了系统搜索。我们纳入了评估 IMA 对急性中风患者诊断准确性的研究。两名审查员独立提取数据并评估检索研究的质量，分歧通过与第三名审查员讨论解决。使用双变量诊断荟萃分析汇总敏感性和特异性。我们计算了 I2 以检验异质性，并使用荟萃回归来确定异质性的潜在来源。本系统评价和荟萃分析已在国际前瞻性系统评价注册中心（注册号 CRD42020149174）注册。
六项研究共纳入 605 例患者符合纳入标准。我们的荟萃分析得出以下结果：IMA 诊断急性中风的平均敏感性为 0.80（95%置信区间 [CI]，0.69-0.88），特异性为 0.80（95% CI，0.71-0.87）。受试者工作特征曲线下面积为 0.86（95% CI，0.83-0.89），合并诊断优势比为 16（95% CI，8-33）。研究之间存在明显的异质性（I2 = 78%，95% CI，53-100）。敏感性分析和荟萃回归可以解释异质性。
IMA 是早期诊断中风的有用标志物。
