Zhang Jingxiao, Zheng Zhifang, Ren Lei, Wang Chenhong, Li Yue, Hu Xidan, Zhang Jie, Jing Xiaoqing, Jin Yuzi
Paediatric Internal Medicine, Affiliated Hospital of Chengde Medical University, Chengde, Hebei Province, China.
J Intensive Care Med. 2024 Aug 2:8850666241267261. doi: 10.1177/08850666241267261.
To investigate the diagnostic value of hepcidin for sepsis diagnosis. The relevant literature on hepcidin for sepsis diagnosis published up to October 20, 2023, was systematically searched in the Web of Science, PubMed, Embase, and China Knowledge Network databases. Two researchers screened the literature and extracted relevant data according to the inclusion and exclusion criteria. Study quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Meta-analysis and calculation of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were performed using State16 and Review Manager 5.3 software. Furthermore, receiver operating characteristic curve (ROC) was plotted, and the respective area under the curve (AUC) was calculated to assess the accuracy of hepcidin. Publication bias was evaluated using Deeks' funnel plot asymmetry test. Overall, 1047 patients from 8 studies were included (625 patients with sepsis and 422 controls). The quality of the literature was relatively moderate. Meta-analysis demonstrated the presence of heterogeneity in the data (> 50%, < .05), and a randomized model was employed to combine the diagnostic indicators. Regarding its accuracy for sepsis diagnosis, hepcidin demonstrated a pooled sensitivity of 0.88 (95% confidence interval [CI]: 0.76-0.94) and specificity of 0.91 (95% CI: 0.76-0.97). The diagnostic odds ratio was 69.00 (95% CI: 19.00-253.00), and the ROC curve revealed an AUC of 0.95. Additionally, Deeks' funnel plot asymmetry test demonstrated absence of publication bias. Our meta-analysis suggested that hepcidin has a high diagnostic value in sepsis and may be a valuable diagnostic tool.
为探讨铁调素对脓毒症诊断的价值。在Web of Science、PubMed、Embase和中国知网数据库中系统检索截至2023年10月20日发表的关于铁调素用于脓毒症诊断的相关文献。两名研究人员根据纳入和排除标准筛选文献并提取相关数据。使用诊断准确性研究质量评估2工具评估研究质量。使用State16和Review Manager 5.3软件进行荟萃分析，并计算敏感度、特异度、阳性似然比、阴性似然比和诊断比值比。此外，绘制受试者工作特征曲线（ROC），并计算各自的曲线下面积（AUC）以评估铁调素的诊断准确性。使用Deeks漏斗图不对称性检验评估发表偏倚。总体而言，纳入了8项研究中的1047例患者（625例脓毒症患者和422例对照）。文献质量相对中等。荟萃分析表明数据存在异质性（>50%，<0.05），采用随机模型合并诊断指标。就其对脓毒症诊断的准确性而言，铁调素的合并敏感度为0.88（95%置信区间[CI]：0.76 - 0.94），特异度为0.91（95%CI：0.76 - 0.97）。诊断比值比为69.00（95%CI：19.00 - 253.00），ROC曲线显示AUC为0.95。此外，Deeks漏斗图不对称性检验表明不存在发表偏倚。我们的荟萃分析表明，铁调素在脓毒症诊断中具有较高的诊断价值，可能是一种有价值的诊断工具。
