■本系统综述和荟萃分析旨在评估川崎病(KD)预后营养指数(PNI)和静脉免疫球蛋白(IVIG)抵抗与冠状动脉病变(CAL)之间的关系。
■在PubMed上搜索了相关文献,Embase,科克伦图书馆,WebofScience,和谷歌学者截至2023年8月5日。汇集的敏感性,特异性,正似然比(PLR),负似然比(NLR),诊断优势比(DOR),计算曲线下面积(AUC)以评估IVIG耐药和CAL的KD患者PNI的预测值。
■共纳入8篇文章,包含10项研究,涉及7,047名参与者。合并结果显示,合并灵敏度为0.44(0.25-0.65),合并特异性为0.87(0.73-0.94),合并PLR为3.4(2.0-5.9),合并的NLR为0.65(0.48-0.87),合并DOR为5.26(2.76-10.02),合并AUC为0.75(0.71-0.78),用于诊断KD和CAL。合并结果表明,合并灵敏度为0.69(0.60-0.77),特异性为0.76(0.69-0.82),PLR为2.9(2.1-4.1),NLR为0.40(0.29-0.56),DOR为7.27(3.89-13.59),诊断有IVIG耐药的KD的AUC为0.79(0.75-0.82)。综合结果显示,合并灵敏度为0.63(0.58-0.67),特异性为0.82(0.80-0.83),PLR为3.09(1.06-8.98),NLR为0.38(0.07-2.02),区分KD与发热患者的DOR为8.23(0.81-83.16)。这些发现表明PNI对KD的敏感性较低,特异性相对较高,KD-CAL,和抗IVIGKD。
■总而言之,本研究首次对PNI在合并IVIG耐药和CAL的KD中的诊断价值进行系统评价和荟萃分析。结果表明,PNI可作为区分KD的生物标志物,KD与CAL,和具有IVIG抗性的KD。
UNASSIGNED: This systematic review and meta-analysis aimed to evaluate the relationship between the prognostic nutritional index (PNI) and intravenous immunoglobulin (IVIG) resistance and coronary artery lesion (CAL) in Kawasaki disease (KD).
UNASSIGNED: The relevant literature was searched on PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar up to August 5, 2023. A pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under curve (AUC) were calculated to assess the predicted values of PNI in KD patients with IVIG resistance and CAL.
UNASSIGNED: A total of 8 articles containing 10 studies involving 7,047 participants were included. The pooled results revealed a pooled sensitivity of 0.44 (0.25-0.65), a pooled specificity of 0.87 (0.73-0.94), a pooled PLR of 3.4 (2.0-5.9), a pooled NLR of 0.65 (0.48-0.87), a pooled DOR of 5.26 (2.76-10.02), and a pooled AUC of 0.75 (0.71-0.78) in the diagnosis of KD with CAL. The pooled results suggested that a pooled sensitivity was 0.69 (0.60-0.77), specificity was 0.76 (0.69-0.82), PLR was 2.9 (2.1-4.1), NLR was 0.40 (0.29-0.56), DOR was 7.27 (3.89-13.59), and AUC was 0.79 (0.75-0.82) in the diagnosis of KD with IVIG resistance. The combined results revealed the pooled sensitivity was 0.63 (0.58-0.67), specificity was 0.82 (0.80-0.83), PLR was 3.09 (1.06-8.98), NLR was 0.38 (0.07-2.02), DOR was 8.23 (0.81-83.16) in differentiating KD from febrile patients. These findings demonstrated low sensitivity and relatively high specificity of PNI for KD, KD-CAL, and IVIG-resistant KD.
UNASSIGNED: In conclusion, this study was the first systematic review and meta-analysis of the diagnostic value of PNI in KD with IVIG resistance and CAL. The results suggested that PNI could be used as biomarkers for distinguish KD, KD with CAL, and KD with IVIG resistance.