摘要
目的系统评价中性粒细胞与淋巴细胞比值(NLR)对中国人群卒中相关性肺炎(SAP)的诊断价值。方法计算机检索Pubmed、Web of Science、Embase、Cochrane Library、Wiley、中国知网、万方数据知识服务平台、中国生物医学文献数据库中NLR对中国人群SAP诊断价值的相关文献,检索时间自建库至2022年5月。提取纳入文献的资料,采用诊断性试验评价工具QUADAS-2进行文献质量评价,运用Stata 17.0进行Meta分析。结果共纳入14篇文献,总样本量为3966例。Meta分析结果显示,NLR诊断中国人群SAP的合并灵敏度为0.79[95%CI(0.73,0.83)],合并特异度为0.80[95%CI(0.73,0.86)],合并阳性似然比为4.00[95%CI(2.80,5.70)],合并阴性似然比为0.27[95%CI(0.21,0.34)],合并诊断比值比(DOR)为15.10[95%CI(8.98,25.40)],拟合受试者工作特征(SROC)曲线分析结果显示,NLR诊断中国人群SAP的AUC为0.86[95%CI(0.82,0.88)]。亚组分析结果显示,NLR诊断中国人群SAP的合并灵敏度的样本量≤300例和入院24 h后采样的研究间无统计学异质性,NLR诊断中国人群SAP的合并灵敏度的其他亚组研究间有统计学异质性,NLR诊断中国人群SAP的合并特异度、合并DOR的各亚组的研究间有统计学异质性。敏感性分析结果显示,逐一剔除纳入文献后结果无明显变化,提示Meta分析结果较稳健;Deeks漏斗图分析结果显示,纳入的研究不存在发表偏倚(P=0.22)。结论NLR对中国人群SAP具有一定诊断价值,可为SAP的诊断及预防提供一定参考依据。但受纳入研究数量、质量以及样本量的限制,上述结论仍有待更多大样本量、多中心的前瞻性研究进行证实。
Objective To systematically evaluate the diagnostic value of neutrophil-to-lymphocyte ratio(NLR)for stroke-associated pneumonia(SAP)in Chinese population.Methods Databases including Pubmed,Web of Science,Embase,Cochrane Library,Wiley,CNKI,Wanfang Data,Chinese Biomedical Database(CBM)were searched for studies on the NLR in diagnosing SAP in Chinese population from inception to May 2022.The data of the included literature were extracted,the diagnostic test evaluation tool QUADAS-2 was used to evaluate the quality of the included literature,and Stata 17.0 was used for meta-analysis.Results A total of 14 articles were included,involving 3966 patients.The results of meta-analysis showed that,the combined sensitivity of NLR in diagnosing SAP in Chinese population was 0.79[95%CI(0.73,0.83)],the combined specificity was 0.80[95%CI(0.73,0.86)],the combined positive likelihood ratio was 4.00[95%CI(2.80,5.70)],the combined negative likelihood ratio was 0.27[95%CI(0.21,0.34)],the combined diagnostic odds ratio(DOR)was 15.10[95%CI(8.98,25.40)],and the summary receiver operating characteristic(SROC)curve analysis showed that the AUC of NLR in diagnosing SAP in Chinese population was 0.86[95%CI(0.82,0.88)].Subgroup analysis results showed that,there was no statistical heterogeneity among the studies on the combined sensitivity of NLR in diagnosing SAP in Chinese population with sample size≤300 and sampled 24 hours after admission,and there was statistical heterogeneity among the studies on the combined sensitivity of NLR in diagnosing SAP in Chinese population with other subgroups;there was statistical heterogeneity among the studies on the combined specificity of NLR in diagnosing SAP in Chinese population with all subgroups.The results of sensitivity analysis showed that there was no significant change after the inclusion of literature one by one,indicating that the results of meta-analysis were relatively stable.The results of Deeks funnel plot showed that there was no publication bias among the included studies(P=0.22).Co
作者
郭清源
刘高
白娅萍
王蕾
蔡恩丽
GUO Qingyuan;LIU Gao;BAI Yaping;WANG Lei;CAI Enli(Yunnan University of Chinese Medicine,Kunming 650500,China)
出处
《实用心脑肺血管病杂志》
2023年第1期85-90,共6页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
云南省科技厅中医药基础研究联合专项面上项目(202101AZ070001-221)
云南省教育厅科学研究基金项目(2021J0411)。
