外周血IL-6对新生儿脓毒症诊断价值的Meta分析

Diagnostic value of interleukin 6 for neonatal sepsis: a Meta analysis

摘要:

目的 系统评价外周血IL-6对新生儿脓毒症的诊断价值。方法 通过计算机检索中国知网、维普、万方、PubMed、Embase、Web of Science、Cochrane 图书馆公开发表的有关文献,检索时间截止至2014年9月。采用QUADAS量表对纳入文献进行质量评估;采用Metadisc1.4及Stata11.0软件进行异质性检验并根据异质性结果选择相应的效应模型进行定量合成;计算敏感度、特异度及其95%CI,绘制汇总受试者工作特征曲线(SROC),并计算曲线下面积(AUC)及Q^*指数。结果 共计33篇文献纳入Meta分析,分析结果显示:外周血IL-6对新生儿脓毒症诊断的敏感度和特异度分别为0.79(95%CI:0.76~0.81)和0.83(95%CI:0.81~0.85),SROC的AUC为0.89,Q^*指数为0.83;IL-6不增高时新生儿脓毒症发生概率为5%,IL-6增高时新生儿脓毒症发生概率提高为60%。结论 外周血IL-6对新生儿脓毒症诊断的敏感度和特异度较高,有助于早期诊断新生儿脓毒症。

Abstract:

Objective To evaluate the diagnostic value of interleukin 6 for neonatal sepsis. Methods The databases of CNKI, VIP, Wangfang, Pubmed, Embase, Web of Science, Cochrane Library were searched (by September 2014) to identify relevantly published studies about estimating the diagnostic value of interleukin 6 for neonatal sepsis. QUADAS tools were used for quality evaluation of the studies. A Meta analysis was performed by employing Meta Disc 1.4 and Stata11.0 software. Heterogeneity of the included articles was tested to select proper efficacy model for calculating pooled weighted sensitivity, specificity and 95%CI. Summary receiver operating characteristic (SROC) curve was made and the area under the curve and Q^* index were calculated. Results A total of 33 studies including 3 135 neonates were enrolled. The sensitivity and specificity of interleukin 6 for the diagnosis of neonatal sepsis were 0.79 (95%CI: 0.76-0.81) and 0.83 (95%CI: 0.81-0.85) respectively. The area under SROC curve of interleukin 6 for the diagnosis of neonatal sepsis was 0.89 and Q^* index was 0.83. The post-test probability of diagnosing neonatal sepsis indicated by negative interleukin 6 was 5%, while that of positive interleukin 6 was 60%. Conclusions Interleukin 6 measurement is useful for the diagnosis of neonatal sepsis with a high sensitivity and specificity.