尿TIMP-2×IGFBP7在脓毒症相关性AKI中早期诊断价值的Meta分析

目的采用Meta分析系统评价尿基质金属蛋白酶组织抑制剂-2（TIMP-2）×胰岛素样生长因子结合蛋白7（IGFBP7）在脓毒症相关性急性肾损伤（AKI）中的早期诊断价值。 方法系统检索PubMed，Web of Science，Cochrane，Embase英文数据库以及中国知网、万方、维普、中国生物医学文献服务系统中文数据库，用RevMan5.3和Meta-Disc1.4软件进行数据处理和分析。 结果共纳入6篇文献592例患者。2项研究来自欧美国家，4项来自中国。TIMP-2×IGFBP7早期预测脓毒症相关性AKI的合并敏感度、特异度、阳性似然比、阴性似然比和诊断比值比及其95%CI分别为0.82（0.76~0.87）、0.59（0.54~0.64）、3.11（1.47~6.56）、0.27（0.13~0.57）和12.92（4.23~39.41）。绘制综合受试者工作特征曲线（sROC）发现TIMP-2×IGFBP7诊断脓毒症相关性AKI的曲线下面积（AUC）为0.8497，Q*为0.7809。亚组分析显示，TIMP-2×IGFBP7在AKI 1期和中国人群中的诊断价值更高，AUC分别为0.9072和0.8920。 结论TIMP-2×IGFBP7对于脓毒症相关性AKI尤其是AKI 1期及中国人群具有较好的早期诊断能力。

Predictive value of urinary TIMP-2×IGFBP7 for sepsis acute kidney injury: a Meta-analysis

ObjectiveTo investigate the predictive value of urinary TIMP-2×IGFBP7 for sepsis acute kidney injury (AKI) by the Meta-analysis. MethodsThe database of PubMed, Web of Science, Cochrane, Embase, CNKI, WanFang, VIP and CBM were searched. Data was analyzed by RevMan 5.3 and Meta-Disc 1.4. ResultsSix studies involving 592 patients were included. Among them, 2 studies were from Western countries, while 4 studies were from China. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio with corresponding 95% confidence interval were 0.82 (0.76-0.87), 0.59 (0.54-0.64), 3.11 (1.47-6.56), 0.27 (0.13-0.57) and 12.92 (4.23-39.41), respectively. The area under the curve for summary receiver operating characteristic curves was 0.8497 with a Q* value of 0.7809. Subgroup analysis showed that the predictive accuracy of TIMP-2×IGFBP7 was higher in stage 1 AKI and Chinese population, with AUCs of 0.9072 and 0.8920, respectively. ConclusionUrinary TIMP-2×IGFBP7 is an early predictive marker for sepsis AKI, especially in stage 1 AKI and Chinese population.