摘要
目的中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)是反应系统性炎症反应的定量指标之一,最近已经有一些研究探索了NLR可以作为反应急性胰腺炎(acute pancreatitis,AP)严重程度的重要指标,但是不同研究间存在不一致性.因此,在这项研究中,我们首次系统性地评估了不同研究中性粒细胞与淋巴细胞比值对急性胰腺炎严重程度的预测价值.方法我们在PubMed,Embase,Web of Science和Cochrane Library数据库中检索2019年4月以前关于中性粒细胞与淋巴细胞比值和胰腺炎的相关文章.三位作者分别独立审查检索到的文章.如果文章是探讨中性粒细胞与淋巴细胞比值预测急性胰腺炎严重程度的文献则纳入研究.如果是个案报道、综述、基础研究、动物实验、会议摘要则被排除.所有纳入文献的质量评分采用诊断准确性研究的质量评估-2指南(Quality Assessment of Diagnostic Accuracy Studies-2 guidelines,QUADAS-2)进行评估.双变量随机效应模型用于中性粒细胞与淋巴细胞比值预测胰腺炎严重程度的效应量的合并.结果:这项研究总共纳入10项研究(1713例患者),合并后的诊断效应量分别如下:敏感度0.76(0.68~0.82)、特异度0.72(0.61~0.81)、阳性似然比2.7(1.8~4.0)、阴性似然比0.34(0.24~0.48)、受试者工作曲线下面积0.79(0.75~0.82)和诊断比值比8(4~16).结论:NLR是一种容易检测且价格低廉的标记物,具有一定的诊断价值,能够预测急性胰腺炎患者的严重程度,从而为临床上急性胰腺炎的治疗提供新的思路.
s are excluded.The quality scores of all included literature were evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 guidelines(QUADAS-2).The bivariate random effect model was used to combine the effects of neutrophil to lymphocyte ratio to predict the severity of pancreatitis.Results This study included a total of 10 studies(1713 patients).The combined diagnostic effects were as follows:sensitivity 0.76(0.68~0.82),specificity 0.72(0.61~0.81),positive likelihood ratio 2.7(1.8~4.0),negative likelihood ratio 0.34(0.24~0.48),area under the receiver operating curve 0.79(0.75~0.82)and diagnostic odds ratio 8(4~16).Conclusion NLR is an easy-to-detect and inexpensive marker with certain diagnostic value,which can predict the severity of patients with acute pancreatitis,thus providing new ideas for clinical treatment of acute pancreatitis.
作者
张文龙
孔伟浩
张剑林
王兴宇
方茂勇
ZHANG Wen-long;KONG Wei-hao;ZHANG Jian-lin(The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《肝胆外科杂志》
2020年第2期113-117,共5页
Journal of Hepatobiliary Surgery
作者简介
通讯作者:方茂勇
