中国循证儿科杂志2013，Vol.8Issue(1)：31-36,6.DOI:10.3969/j.issn.1673-5501.2013.01.007
C反应蛋白对不明原因发热儿童严重细菌感染诊断价值的系统评价
Diagnostic value of C-reactive protein for detection of serious bacterial infections in children with fever without apparent causes: systematic review
温杨 1郭妍伶 1邓思燕 1朱渝 1舒敏 1郭琴 1廖琼 1万朝敏1
作者信息
摘要
Abstract
Objective To conduct a systematic review to identify the diagnostic value of C-reactive protein for detecting serious bacterial infections in children with fever without apparent causes. Methods Medline, EMBASE, Cochrane Library, VIP Information, China National Knowledge Infrastructure, Wanfang Chinese Periodical Database and Chinese Biomedical Database were searched. QUADAS was used for the quality assessment of included studies, and software MetaDisc 1.4 was used for the test of heterogeneity and meta-analysis. Results Seven studies (n=2 179) were included for the review. Six of them were prospective studies, while one was a retrospective study. None of the studies was assessed with high methodological quality. The prevalence of serious bacterial infections ranged from 1. 7% to 29. 3%. Multivariate logistic analysis conducted in four studies showed that C-reactive protein was an independent predictor. The sensitivities and specificities of the C-reactive protein with different optimal cutoffs were ranged from 33% to 89% , and 75% to 97% respectively. Random effects meta-analysis yielded a pooled positive likelihood ratio of 4. 43 (95% CI∶3. 49 - 5. 63 ) , and a negative likelihood ratio of 0. 39 (95% CI∶0. 29 - 0. 54). The area under the summary receiver operating characteristic curve was 0. 85 , and Q index was 0. 78. Conclusions C-reactive protein provides a good diagnostic value in infants and young children with fever without apparent causes, it should be applied in combination with clinical features and other tests.关键词
C反应蛋白/不明原因发热/儿童/严重细菌感染/诊断价值/系统评价Key words
C-reactive protein/ Fever without source/ Children/ Serious bacterial infections/ Diagnostic value/ Systematic review引用本文复制引用
温杨,郭妍伶,邓思燕,朱渝,舒敏,郭琴,廖琼,万朝敏..C反应蛋白对不明原因发热儿童严重细菌感染诊断价值的系统评价[J].中国循证儿科杂志,2013,8(1):31-36,6.
