目的:系统总结所有相关数据,并定义Pentraxin-3(PTX3)作为儿童急性阑尾炎(AA)生物标志物的当前证据。
方法:本综述按照PRISMA指南进行。PubMed,Embase,Scopus,系统搜索了WebofScience数据库,以比较AA患者与健康对照或非特异性腹痛(NSAP)患者的PTX3水平。计算所有结果的平均差,并使用逆方差方法进行加权平均差。使用Downs和Black量表评估纳入研究的方法学质量。
结果:纳入了5项比较研究。与健康对照组相比,AA患者的PTX3水平显着升高(WMD:9.56,95%CI7.24-11.88,p<0.00001),AA和NSAP患者(WMD:8.05,95%CI6.81-9.29,p<0.00001)。同样,在单独的荟萃分析中,与健康对照组相比,AA儿童的PTX3水平显着升高(WMD:11.18,95%CI10.03-12.34,p<0.00001),和儿童AAvsNSAP(WMD:8.35,95%CI6.88-9.82,p<0.00001)。
结论:PTX3水平在AA中升高,但穿孔和非穿孔阑尾炎之间的区别需要其他方法。
OBJECTIVE: To systematically summarize all relevant data and to define the current evidence on the utility of Pentraxin-3 (PTX3) as a biomarker for acute appendicitis (AA) in children.
METHODS: This
review was conducted in accordance with the PRISMA guidelines. PubMed, Embase, Scopus, and Web of Science databases were systematically searched for studies comparing the levels of PTX3 in patients with AA vs healthy controls or non-specific abdominal pain (NSAP). Mean differences were calculated for all outcomes and the inverse variance method was used for weighted mean difference. The methodological quality of the included studies was assessed using the Downs and Black scale.
RESULTS: Five comparative studies were included. Significantly elevated levels of PTX3 in cases with AA vs healthy controls (WMD: 9.56, 95% CI 7.24-11.88, p < 0.00001), and patients with AA vs NSAP (WMD: 8.05, 95% CI 6.81-9.29, p < 0.00001) were demonstrated. Similarly, in separate meta-analyses, the levels of PTX3 were significantly elevated in children with AA vs healthy controls (WMD: 11.18, 95% CI 10.03-12.34, p < 0.00001), and children with AA vs NSAP (WMD: 8.35, 95% CI 6.88-9.82, p < 0.00001).
CONCLUSIONS: PTX3-levels are elevated in AA, but differentiation between perforated and non-perforated appendicitis demands other methods.