Department of Respiratory Medicine, The Second Hospital of Jilin University, 218 Ziqiang Street, Nanguan District, Changchun, 130041, Jilin Province, China.
BMC Infect Dis. 2021 Apr 26;21(1):384. doi: 10.1186/s12879-021-06064-0.
The aim of the study was to conduct a meta-analysis to evaluate the accuracy of neutrophil CD64, procalcitonin (PCT), and interleukin-6 (IL-6) as markers for the diagnosis of sepsis in adult patients.
Various databases were searched to collect published studies on the diagnosis of sepsis in adult patients using neutrophil CD64, PCT, and IL-6 levels. Utilizing the Stata SE 15.0 software, forest plots and the area under the summary receiver operating characteristic curves were drawn. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC) were calculated.
Fifty-four articles were included in the study. The pooled sensitivity, specificity, and AUC of neutrophil CD64 for the diagnosis of sepsis were 0.88 (95% confidence interval [CI], 0.81-0.92), 0.88 (95% CI, 0.83-0.91), and 0.94 (95% CI, 0.91-0.96), respectively. The pooled sensitivity, specificity, and AUC of PCT for the diagnosis of sepsis were 0.82 (95% CI, 0.78-0.85), 0.78 (95% CI, 0.74-0.82), and 0.87 (95% CI, 0.83-0.89), respectively. Subgroup analysis showed that the AUC for PCT diagnosis of intensive care unit (ICU) sepsis was 0.86 (95% CI, 0.83-0.89) and the AUC for PCT diagnosis of non-ICU sepsis was 0.82 (95% CI, 0.78-0.85). The pooled sensitivity, specificity, and AUC of IL-6 for the diagnosis of sepsis were 0.72 (95% CI, 0.65-0.78), 0.70 (95% CI, 0.62-0.76), and 0.77 (95% CI, 0.73-0.80), respectively.
Of the three biomarkers studied, neutrophil CD64 showed the highest diagnostic value for sepsis, followed by PCT, and IL-6. On the other hand, PCT showed a better diagnostic potential for the diagnosis of sepsis in patients with severe conditions compared with that in patients with non-severe conditions.
本研究旨在进行荟萃分析，以评估中性粒细胞 CD64、降钙素原（PCT）和白细胞介素-6（IL-6）作为成人脓毒症诊断标志物的准确性。
检索了各种数据库，以收集使用中性粒细胞 CD64、PCT 和 IL-6 水平诊断成人脓毒症的已发表研究。使用 Stata SE 15.0 软件绘制森林图和汇总受试者工作特征曲线下面积。计算了合并的敏感性、特异性、阳性似然比、阴性似然比、诊断比值比和曲线下面积（AUC）。
共纳入 54 篇文章。中性粒细胞 CD64 对脓毒症诊断的合并敏感性、特异性和 AUC 分别为 0.88（95%置信区间 [CI]，0.81-0.92）、0.88（95% CI，0.83-0.91）和 0.94（95% CI，0.91-0.96）。PCT 对脓毒症诊断的合并敏感性、特异性和 AUC 分别为 0.82（95% CI，0.78-0.85）、0.78（95% CI，0.74-0.82）和 0.87（95% CI，0.83-0.89）。亚组分析显示，PCT 对 ICU 脓毒症的诊断 AUC 为 0.86（95% CI，0.83-0.89），PCT 对非 ICU 脓毒症的诊断 AUC 为 0.82（95% CI，0.78-0.85）。IL-6 对脓毒症诊断的合并敏感性、特异性和 AUC 分别为 0.72（95% CI，0.65-0.78）、0.70（95% CI，0.62-0.76）和 0.77（95% CI，0.73-0.80）。
在这三种生物标志物中，中性粒细胞 CD64 对脓毒症的诊断价值最高，其次是 PCT 和 IL-6。另一方面，与非重症患者相比，PCT 对重症患者脓毒症的诊断具有更好的诊断潜力。
