和肽素检测对急性心肌梗死诊断效能的Meta分析
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摘要
目的评价和肽素检测对急性心肌梗死(Acute Myocardial Infarction,AMI)的诊断效能。方法采用荟萃(Meta)分析,全面检索Pub Med、Medline、EMBASE、Cochrane、中国知网、万方、维普数据库,收集建库至2017年8月关于和肽素检测用于诊断AMI的中英文文献,使用Meta-Di Sc1.4与Stata12.0来分析数据。结果纳入10篇文献,均为高质量文献,共计5 344例研究对象。按随机效应模型计算(95%CI),合并敏感性为77%(74%~80%),合并特异性为65%(63%~66%),合并曲线下面积为0.7545(0.7269~0.7821)。结论和肽素检测对AMI具有一定的判别效果,尤其在非ST段抬高型心肌梗死的诊断上应用较广泛,与其它指标进行联合检测有助于提高诊断效能。
Objective To evaluate the value of copeptin detection for the diagnosis of acute myocardial infarction( AMI).Methods Meta-analysis was used to comprehensively search Pub Med,Medline,EMBASE,Cochrane,CNKI,Wanfang,and VIP databases,and collected Chinese and English literatures on the use of copeptin for diagnosis of AMI in August 2017. Meta-Di Sc1. 4 and Stata12. 0 software were used to analyze the data. Results A total of 10 relevant studies with high quality were enrolled,including 5344 patients. 95% CI was calculated with the random effect model. The pooled sensitivity was 77%( 74%-80%),the pooled specificity was 65%( 63%-66%) and the summary area under the curve was 0. 7545( 0. 7269 ~ 0. 7821).Conclusion The copeptin detection has a certain distinguishable effect on the diagnosis of AMI,especially in the diagnosis of non-st-segment elevation myocardial infarction. And the combined detection with other markers can improve the diagnostic value.
Objective To evaluate the value of copeptin detection for the diagnosis of acute myocardial infarction( AMI).Methods Meta-analysis was used to comprehensively search Pub Med,Medline,EMBASE,Cochrane,CNKI,Wanfang,and VIP databases,and collected Chinese and English literatures on the use of copeptin for diagnosis of AMI in August 2017. Meta-Di Sc1. 4 and Stata12. 0 software were used to analyze the data. Results A total of 10 relevant studies with high quality were enrolled,including 5344 patients. 95% CI was calculated with the random effect model. The pooled sensitivity was 77%( 74%-80%),the pooled specificity was 65%( 63%-66%) and the summary area under the curve was 0. 7545( 0. 7269 ~ 0. 7821).Conclusion The copeptin detection has a certain distinguishable effect on the diagnosis of AMI,especially in the diagnosis of non-st-segment elevation myocardial infarction. And the combined detection with other markers can improve the diagnostic value.
引文
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[11]李伟宁,魏殿军,宁莉.和肽素与肌钙蛋白联合检测在急性心肌梗死期诊断中的应用价值[J].天津医药,2015,43(11):1319-1321,1322.
[12]卢章,罗菲菲,邱创华,等.和肽素、磷酸激酶心肌同工酶及高敏肌钙蛋白在急性冠脉综合征中的诊断价值[J].广东医学,2017,38(16):2489-2492.
[13]Ay MO,Erenler AK,Dogan T,et al.Diagnostic value of copeptin in acute myocardial infarction[J].European Review for Medical and Pharmacological Sciences,2017,21(7):1576-1582.
[14]漆丹平.探讨血清缺血修饰白蛋白和肌红蛋白联合检测对急性心肌梗死早期诊断的临床价值[J].中国实验诊断学,2017,21(04):595-597.
[15]Lipinski MJ,Escarcega RO,D'ascenzo F,et al.A systematic review and collaborative Meta-Analysis to determine the incremental value of copeptin for rapid Rule-Out of acute myocardial infarction[J].American Journal of Cardiology,2014,113(9):1581-1591.
[16]Alquézar A,SantalóM,Rizzi M,et al.Combined high-sensitivity copeptin and troponin T evaluation for the diagnosis of non-STelevation acute coronary syndrome in the emergency department[J].Emergencias,2017,29(4):237-244.
[17]Raskovalova T,Twerenbold R,Collinson PO,et al.Diagnostic accuracy of combined cardiac troponin and copeptin assessment for early rule-out of myocardial infarction:a systematic review and meta-analysis[J].European heart journal.Acute cardiovascular care,2014,3(1):18-27.
[18]杨靓淇,谭向宇,沈文,等.肌钙蛋白单独与联合和肽素早期诊断非ST段抬高型心肌梗死临床价值的Meta分析[J].中国循环杂志,2016,31(8):750-754.
[19]应凯强,周琳,徐丛荣.肌钙蛋白联合和肽素对急性心肌梗死早期诊断价值的荟萃分析[J].临床检验杂志,2017,35(3):234-238.
[20]Nebiker CA,Staubli S,Schfer J,et al.Cortisol outperforms novel cardiovascular,inflammatory,and neurohumoral biomarkers in the prediction of outcome in acute pancreatitis[J].Pancreas,2018,47(1):55-64.
[2]Beglinger S,Drewe J,Christ-Crain M.The circadian rhythm of copeptin,the C-Terminal portion of arginine vasopressin[J].Journal of biomarkers,2017,2017:4737082.
[3]Lewandowski KC,Brabant G.Potential clinical utility of copeptin(c-terminal provasopressin)measurements in clinical medicine[J].Experimental and clinical endocrinology&diabetes:official journal,German Society of Endocrinology[and]German Diabetes Association,2016,124(3):173-177.
[4]Keller T,Tzikas S,Zeller T,et al.Copeptin improves early diagnosis of acute myocardial infarction[J].Journal of the American College of Cardiology,2010,55(19):2096-2106.
[5]Meune C,Zuily S,Wahbi K,et al.Combination of copeptin and high-sensitivity cardiac troponin T assay in unstable angina and nonST-segment elevation myocardial infarction:a pilot study[J].Archives of Cardiovascular Diseases,2011,104(1):4-10.
[6]Charpentier S,Maupas-Schwalm F,Cournot M,et al.Combination of copeptin and troponin assays to rapidly rule out non-STelevation myocardial infarction in the emergency department[J].Academic emergency medicine:official journal of the Society for Academic Emergency Medicine,2012,19(5):517-524.
[7]Sebbane M,Lefebvre S,Kuster N,et al.Early rule out of acute myocardial infarction in ED patients:value of combined highsensitivity cardiac troponin T and ultrasensitive copeptin assays at admission[J].American Journal of Emergency Medicine,2013,31(9):1302-1308.
[8]Chenevier-Gobeaux C,Freund Y,Claessens YE,et al.Copeptin for rapid rule out of acute myocardial infarction in emergency department[J].International Journal of Cardiology,2013,166(1):198-204.
[9]Maisel A,Mueller C,Neath SX,et al.Copeptin helps in the early detection of patients with acute myocardial infarction:primary results of the CHOPIN trial(Copeptin Helps in the early detection Of Patients with acute myocardial INfarction)[J].Journal of the American College of Cardiology,2013,62(2):150-160.
[10]张浩,任国庆,孙文文,等.检测和肽素及肌钙蛋白I对急性非ST段抬高型心肌梗死的早期诊断价值[J].实用医学杂志,2014,30(19):3096-3098,3099.
[11]李伟宁,魏殿军,宁莉.和肽素与肌钙蛋白联合检测在急性心肌梗死期诊断中的应用价值[J].天津医药,2015,43(11):1319-1321,1322.
[12]卢章,罗菲菲,邱创华,等.和肽素、磷酸激酶心肌同工酶及高敏肌钙蛋白在急性冠脉综合征中的诊断价值[J].广东医学,2017,38(16):2489-2492.
[13]Ay MO,Erenler AK,Dogan T,et al.Diagnostic value of copeptin in acute myocardial infarction[J].European Review for Medical and Pharmacological Sciences,2017,21(7):1576-1582.
[14]漆丹平.探讨血清缺血修饰白蛋白和肌红蛋白联合检测对急性心肌梗死早期诊断的临床价值[J].中国实验诊断学,2017,21(04):595-597.
[15]Lipinski MJ,Escarcega RO,D'ascenzo F,et al.A systematic review and collaborative Meta-Analysis to determine the incremental value of copeptin for rapid Rule-Out of acute myocardial infarction[J].American Journal of Cardiology,2014,113(9):1581-1591.
[16]Alquézar A,SantalóM,Rizzi M,et al.Combined high-sensitivity copeptin and troponin T evaluation for the diagnosis of non-STelevation acute coronary syndrome in the emergency department[J].Emergencias,2017,29(4):237-244.
[17]Raskovalova T,Twerenbold R,Collinson PO,et al.Diagnostic accuracy of combined cardiac troponin and copeptin assessment for early rule-out of myocardial infarction:a systematic review and meta-analysis[J].European heart journal.Acute cardiovascular care,2014,3(1):18-27.
[18]杨靓淇,谭向宇,沈文,等.肌钙蛋白单独与联合和肽素早期诊断非ST段抬高型心肌梗死临床价值的Meta分析[J].中国循环杂志,2016,31(8):750-754.
[19]应凯强,周琳,徐丛荣.肌钙蛋白联合和肽素对急性心肌梗死早期诊断价值的荟萃分析[J].临床检验杂志,2017,35(3):234-238.
[20]Nebiker CA,Staubli S,Schfer J,et al.Cortisol outperforms novel cardiovascular,inflammatory,and neurohumoral biomarkers in the prediction of outcome in acute pancreatitis[J].Pancreas,2018,47(1):55-64.