关节液 D-乳酸对人工关节周围感染的诊断准确性：系统评价和荟萃分析。
Diagnostic accuracy of synovial fluid D-lactate for periprosthetic joint infection: a systematic review and meta-analysis.
机构信息
Department of Orthopedics, Peking University China-Japan Friendship School of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China.
Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China.
出版信息
J Orthop Surg Res. 2021 Oct 16;16(1):606. doi: 10.1186/s13018-021-02778-8.
BACKGROUND
Periprosthetic joint infection is a grievous complication after arthroplasty that greatly affects the quality of life of patients. Rapid establishment of infection diagnosis is essential, but great challenges still exist.
METHODS
We conducted research in the PubMed, Embase, and Cochrane databases to evaluate the diagnostic accuracy of D-lactate for PJI. Data extraction and quality assessment were completed independently by two reviewers. The pooled sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR), summarized receiver operating characteristic curve (sROC), and area under the sROC curve (AUC) were constructed using the bivariate meta-analysis framework.
RESULTS
Five eligible studies were included in the quantitative analysis. The pooled sensitivity and specificity of D-lactate for the diagnosis of PJI were 0.82 (95% CI 0.70-0.89) and 0.76 (95% CI 0.69-0.82), respectively. The value of the pooled diagnostic odds ratio (DOR) of D-lactate for PJI was 14.18 (95% CI 6.17-32.58), and the area under the curve (AUC) was 0.84 (95% CI 0.80-0.87).
CONCLUSIONS
According to the results of our meta-analysis, D-lactate is a valuable synovial fluid marker for recognizing PJI, with high sensitivity and specificity.
背景
人工关节置换术后发生的假体周围关节感染是一种严重的并发症，极大地影响了患者的生活质量。快速确立感染诊断至关重要，但仍存在巨大挑战。
方法
我们在 PubMed、Embase 和 Cochrane 数据库中进行了研究，以评估 D-乳酸对 PJI 的诊断准确性。两名评审员独立完成数据提取和质量评估。使用双变量荟萃分析框架构建汇总敏感性、特异性、似然比、诊断比值比（DOR）、汇总受试者工作特征曲线（sROC）和 sROC 下面积（AUC）。
结果
五项符合条件的研究纳入定量分析。D-乳酸对 PJI 诊断的汇总敏感性和特异性分别为 0.82（95% CI 0.70-0.89）和 0.76（95% CI 0.69-0.82）。D-乳酸对 PJI 的汇总诊断比值比（DOR）值为 14.18（95% CI 6.17-32.58），曲线下面积（AUC）为 0.84（95% CI 0.80-0.87）。
结论
根据荟萃分析结果，D-乳酸是一种识别 PJI 的有价值的关节液标志物，具有较高的敏感性和特异性。
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