尿中性粒细胞明胶酶相关脂质运载蛋白对泌尿道感染诊断作用的荟萃分析

目的:通过荟萃分析探讨尿中性粒细胞明胶酶相关脂质运载蛋白（NGAL）对泌尿道感染的诊断作用。方法:检索PubMed、Embase、中国知网（CNKI）、万方数据库，搜索时间为建库至2021年11月。2位研究者独立评判了这些研究，并提取了数据。采用STATA 12.0软件行meta分析，包括评价特异度、灵敏度、似然比和诊...

Urinary neutrophil gelatinase-associated lipocalin as a diagnostic marker for urinary tract infection: a systematic review and meta-analysis

Objective　To study the value of urinary neutrophil gelatinase-associated lipocalin(NGAL) in the diagnosis of urinary tract infection (UTI) through a metaanalysis. Methods　PubMed, Embase, ChinaNational Knowledge Infrastructure (CNKI), and Wanfang Database were searchedfor related studies published up to November 2021. Two researchersindependently judged the studies and extracted the data. Meta analysis wasperformed by STATA 12.0 software, including evaluation of specificity,sensitivity, likelihood ratio, and odds ratio and drawing summary receiveroperating characteristic curve (SROC) and Fagan diagram. Results　In all, 14 studies were enrolled, including 2 362 children andadolescents. The studies were highly heterogeneous, and there was no thresholdeffect or publication bias. Using a bivariate random effect regression model,we found that for the diagnosis of urinary tract infection, urinary NGAL'ssummary specificity and sensitivity were 0.82 (95%CI: 0.74-0.88) and 0.82 (95%CI:0.73-0.89) respectively. Additionally, the negative likelihood ratio, positivelikelihood ratio, and diagnostic odds ratio were 4.58 (95%CI: 2.81-7.46), 0.22 (95%CI:0.14-0.34), and 20.66 (95%CI:8.64-49.38) respectively. The area under the SROC was 0.89 (95%CI: 0.86-0.91). According to the Fagandiagram, application of urine NGAL to detect urinary tract infection enhancedthe prior probability to 20%, increased the probability of positivity to 53%,and reduced the probability of negativity to 5%. Based on the meta-regressionanalysis, the heterogeneity was due to other covariates. Conclusions　Urinary NGAL is highly effective in diagnosing urinary tract infectionin the early stage. Although urinary NGAL may be used in the diagnosis ofurinary tract infection, a comprehensive evaluation and analysis of clinicalparameters should be performed on every patient.