中性粒细胞-淋巴细胞比值在新亚特兰大分类标准下对重症急性胰腺炎早期预测价值的Meta分析和系统评价

目的系统评价中性粒细胞-淋巴细胞比值（NLR）在新亚特兰大分类标准下对重症急性胰腺炎（SAP）早期预测的价值。 方法计算机检索中国知网、万方、维普、PubMed、Embase、Web of Science及Cochrane Library数据库自建库至2021年1月发表的关于NLR对SAP预测价值的相关文献。两位评价者对文献严格按照纳入和排除标准独立筛选和资料提取，采用QUADAS-2量表进行质量评价。使用STATA 15.1和Meta-DiSc1.4软件进行统计学分析，双变量混合效应模型用于计算合并的敏感度、特异度、阳性似然比、阴性似然比和诊断优势比，并绘制综合受试者工作特征曲线。 结果最终纳入12篇文献2 299例患者，其中SAP患者337例。NLR对SAP预测价值的敏感度、特异度、阳性似然比、阴性似然比和诊断优势比分别为0.79（95% CI：0.72~0.84）、0.76（95% CI：0.70~0.81）、3.26（95% CI：2.64~4.03）、0.28（95% CI：0.22~0.37）、11.55（95% CI：7.93~16.81），综合受试者工作特征曲线下面积为0.84（95% CI：0.81~0.87）。 结论NLR作为一项反映全身炎性反应水平快速、简便且价格低廉的指标，对早期预测SAP具有一定的临床价值。

Role of neutrophil to lymphocyte ratio in the early prediction of severe acute pancreatitis based on the revised Atlanta classification: A systematic review and Meta-analysis

ObjectiveTo systematically evaluate the clinical efficacy of neutrophil to lymphocyte ratio (NLR) in the early prediction of severe acute pancreatitis (SAP) based on the revised Atlanta classification. MethodsA systematic search was conducted using CNKI, Wanfang, VIP, PubMed, Web of Science, Cochrane library and Embase databases from the date of establishment to January 2021. Two independent authors evaluated the eligibility of the studies and performed data extraction. The QUADAS-2 was used to assess the quality of diagnostic accuracy studies included in this meta-analysis. Statistical analyses were performed using the STATA 15.1 and Meta-DiSc1.4 software. Pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), diagnosis of odds ratio (DOR) and symmetric receiver operator characteristic (SROC) curves, as well as the area under the SROC curve (AUC), were assessed using the bivariate mixed effects models. ResultsTotally 12 studies with 2 299 patients were included, containing 337 SAP patients. The pooled sensitivity, specificity, LR+, LR- and DOR of the NLR for predicting SAP were 0.79 (95% CI: 0.72-0.84), 0.76 (95% CI: 0.70-0.81), 3.26 (95% CI: 2.64-4.03), 0.28 (95% CI: 0.22-0.37), 11.55 (95% CI: 7.93-16.81), respectively. The AUC was 0.84 (95% CI: 0.81-0.87). ConclusionNLR is a readily available and convenient marker reflecting the level of systemic inflammatory response, with a certain clinical value in early prediction of SAP.