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目的系统评价文献资料针对中性粒细胞CD64诊断新生儿败血症的准确性。方法检索Pub Med、Embase和Springer数据库,截止日期为2015年3月18日。提取符合纳入标准文献的相关数据进行分析,以敏感度和特异度为基础绘制汇总受试者工作特征(SROC)曲线,应用Meta-Disc 1.4软件进行Spearman相关分析,检测有无阈值效应引起的异质性。结果共纳入16项研究,包括病例2 804例。中性粒细胞CD64诊断新生儿败血症的汇总敏感度为0.72(95%CI0.70~0.74),特异度为0.78(95%CI 0.76~0.80),阳性似然比为3.87(95%CI 2.99~5.00),阴性似然比为0.26(95%CI 0.18~0.36),诊断比值比为17.22(95%CI 9.98~29.70),SROC曲线下面积为0.8746。Spearman相关性分析提示无阈值效应(P=0.987)。结论中性粒细胞CD64不应作为新生儿败血症的单独诊断指标,应与其他方法联合应用以提高诊断准确性。
Objective To evaluate the accuracy of neutrophil CD64 in the diagnosis of neonatal sepsis. Methods The Pub Med, Embase and Springer databases were searched by the deadline of March 18, 2015. The relevant data were extracted for inclusion in the standard literature, and the SROC curve was drawn based on the sensitivity and specificity. Spearman correlation analysis was performed with Meta-Disc 1.4 software to detect the presence or absence of threshold effects Qualitative. Results A total of 16 studies were included, including 2 804 cases. The pooled sensitivities of neutrophil CD64 in diagnosis of neonatal sepsis were 0.72 (95% CI 0.70-0.74), specificity of 0.78 (95% CI 0.76-0.80) and positive likelihood ratio of 3.87 (95% CI 2.99 ~ 5.00). The negative likelihood ratio was 0.26 (95% CI 0.18-0.36). The diagnostic odds ratio was 17.22 (95% CI 9.98-29.70). The area under the SROC curve was 0.8746. Spearman correlation analysis showed no threshold effect (P = 0.987). Conclusion Neutrophil CD64 should not be used as a single diagnostic indicator of neonatal sepsis, should be combined with other methods to improve the diagnostic accuracy.