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轻度胃肠炎伴良性惊厥的实验室检查结果:一项荟萃分析

Laboratory Findings of Benign Convulsions With Mild Gastroenteritis: A Meta-Analysis.

作者信息

Miyagi Yoshifumi, Sasano Tomoyuki, Kin Kentoku

机构信息

Department of Pediatrics, Haibara General Hospital, Shizuoka, JPN.

Department of Obstetrics and Gynecology, Osaka Saiseikai Nakatsu Hospital, Osaka, JPN.

出版信息

Cureus. 2023 Mar 28;15(3):e36784. doi: 10.7759/cureus.36784. eCollection 2023 Mar.

Abstract

Investigating factors associated with benign convulsions with mild gastroenteritis (CwG) is important for early detection and treatment. In previous studies, uric acid (UA) has been reported to be associated with CwG. However, the association between CwG and abnormal laboratory values remains inconclusive. We performed a meta-analysis of recent reports to determine the association between CwG and laboratory findings, including UA, in patients with acute gastroenteritis without convulsions. We conducted electronic searches of three databases (PubMed, EMBASE, and Cochrane Library) and one scholarly search engine (Google Scholar (Google, Inc., Mountain View, CA, USA)) up to February 2023 for studies on CwG. Eligible studies were observational studies that assessed patients with CwG, reported laboratory data, and stated the presence or absence of convulsions during illness episodes. Patients were children with mild gastroenteritis, with the exposure group developing convulsions and the control group not. The outcome was a comparison of laboratory data between the two groups. The effect size was calculated using the standardized mean difference (SMD), and random-effects models were used for the analysis because of high heterogeneity. In total, 148 articles were included in this study. After the screening, nine studies, including 8,367 patients, were selected for the meta-analysis. The most prevalent laboratory finding was an increased serum UA level, with an SMD of 1.42 (N = 6,411; 95% confidence interval (CI): (1.12, 1.72); Z = 9.242, p< 0.001; I = 81.68%, p= 0.002). The optimal serum UA cutoff value was 7.21 mg/dL, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.827 (95% CI: (0.807, 0.846)). This meta-analysis suggests that CwG is strongly associated with increased serum UA levels. These results demonstrate that more attention should be paid when interpreting laboratory findings in pediatric patients with acute gastroenteritis.

摘要

研究与轻度肠胃炎伴良性惊厥(CwG)相关的因素对于早期发现和治疗至关重要。在先前的研究中,据报道尿酸(UA)与CwG有关。然而,CwG与实验室异常值之间的关联仍无定论。我们对近期报告进行了一项荟萃分析,以确定CwG与无惊厥的急性肠胃炎患者实验室检查结果(包括UA)之间的关联。我们对三个数据库(PubMed、EMBASE和Cochrane图书馆)以及一个学术搜索引擎(谷歌学术(谷歌公司,美国加利福尼亚州山景城))进行了电子检索,截至2023年2月,以查找关于CwG的研究。符合条件的研究为观察性研究,评估了CwG患者,报告了实验室数据,并说明了疾病发作期间惊厥的有无。患者为轻度肠胃炎儿童,暴露组出现惊厥,对照组未出现。结果是两组之间实验室数据的比较。效应量使用标准化均数差(SMD)计算,由于异质性高,采用随机效应模型进行分析。本研究共纳入148篇文章。筛选后,选择了9项研究,包括8367名患者进行荟萃分析。最常见的实验室检查结果是血清UA水平升高,SMD为1.42(N = 6411;95%置信区间(CI):(1.12,1.72);Z = 9.242,p < 0.001;I² = 81.68%,p = 0.002)。血清UA的最佳截断值为7.21 mg/dL,受试者工作特征(ROC)曲线下面积(AUC)为0.827(95% CI:(0.807,0.846))。这项荟萃分析表明,CwG与血清UA水平升高密切相关。这些结果表明,在解读急性肠胃炎儿科患者的实验室检查结果时应给予更多关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb94/10145619/54788b460f7c/cureus-0015-00000036784-i01.jpg

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