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【文摘发布】BJOG（2007年7月）——（系统评价）
用C反应蛋白预测未足月胎膜早破的患者绒毛膜羊膜炎的价值(系统评价）
RD Trochez-Martinez,aa Women and Children Division, Gynaecology and Obstetrics Directorate, Torbay Hospital, Devon, UKDr RD Trochez-Martinez, Level 4 Maternity Unit, Torbay Hospital, Lawes Bridge, Torquay, Devon TQ2 7AA, UK. Email ruben.trochez-martinez@nhs.net P Smith,bb The Chilterns, Women & Children’s Health, Southmead Hospital, Bristol, UK RF Lamontcc Women and Children Division, Northwick Park Hospital, Middlesex, UKa Women and Children Division, Gynaecology and Obstetrics Directorate, Torbay Hospital, Devon, UK b The Chilterns, Women & Children’s Health, Southmead Hospital, Bristol, UK c Women and Children Division, Northwick Park Hospital, Middlesex, UK
Dr RD Trochez-Martinez, Level 4 Maternity Unit, Torbay Hospital, Lawes Bridge, Torquay, Devon TQ2 7AA, UK. Email ruben.trochez-martinez@nhs.net
Abstract
摘要
Background Studies examining the use of C-reactive protein (CRP) as a predictor of chorioamnionitis in preterm prelabour rupture of membranes (PPROM) report highly conflicting results. Despite this, CRP is commonly used for the early diagnosis of chorioamnionitis.
背景：关于用C反应蛋白预测未足月胎膜早破的患者绒毛膜羊膜炎的研究结果大相径庭。尽管如此，CRP仍作为常用的绒毛膜羊膜炎的早期诊断指标。
Objective To determine the diagnostic accuracy of CRP in the of chorioamnionitis in women with PPROM.
目的：探讨CRP用于未足月胎膜早破的患者绒毛膜羊膜炎的诊断准确性。
Design Systematic review.
设计：系统综述
Search strategy Studies were identified from MEDLINE (1966–2006), EMBASE (1974–2006), PubMed and the Cochrane Library (2005) and from reference lists from primary studies and reviews.
检索策略：检索MEDLINE (1966–2006), EMBASE (1974–2006), PubMed and the Cochrane Library (2005)的研究以及主要研究和综述的参考文献。
Selection criteria Only studies of good methodological quality that evaluated the diagnostic performance of CRP in chorioamnionitis in women with PPROM were selected.
纳入标准：只选择C反应蛋白用于未足月胎膜早破的患者绒毛膜羊膜炎诊断方法学质量高的研究
Data collection and analysis Positive and negative likelihood ratios (LR) and diagnostic odds ratios (DOR) were calculated. An attempt was made at pooling data for meta-analysis, but this was considered inappropriate due to the significant unexplained heterogeneity between studies.
数据收集和分析：计算阳性和阴性似然比(LR) 和诊断比值比。试图进行meta分析，但由于各研究之间不明原因的明显的异质性，故认为不适合进行meta分析。
Main results There were eight primary studies comprising 610 cases which met the inclusion criteria. There was wide variation in the positive and negative LR and DOR between the studies, with significant lack of precision demonstrated by wide confidence intervals. Three of the studies concluded that CRP was a useful diagnostic tool for chorioamnionitis (DOR ranging from 4.2 to 191.6), although one of them suggested a higher CRP threshold. The other five studies concluded the opposite (DOR ranging from 1.4 to 17.7).
主要结果：有8个主要研究包含610例患者被纳入。各研究之间阳性和阴性似然比(LR) 和诊断比值比有很大变异，由于可信区间宽，说明明显缺乏精确性。3项研究显示CRP是一种用于诊断绒毛膜羊膜炎有效的工具(DOR范围 4.2 --191.6)，尽管其中之一认为CRP阈值更高。另外5项研究得出相反的结论(DOR 范围1.4-- 17.7)。
Author’s conclusions There is no clear evidence to support the use of CRP for the early diagnosis of chorioamnionitis. Further research is required to address the contradictory findings of diagnostic accuracy.
作者结论：没有明显证据支持CRP在绒毛膜羊膜炎的早期诊断中的应用。需要更进一步的研究定位这些诊断精确性的研究的相反地发现。
编译：
题目：用C反应蛋白预测未足月胎膜早破的患者绒毛膜羊膜炎的价值的系统评价
RD Trochez-Martinez等博士系统评价表明没有明显证据支持C反应蛋白用于预测未足月胎膜早破的患者绒毛膜羊膜炎,发表于BJOG（2007年7月）
关于用C反应蛋白预测未足月胎膜早破的患者绒毛膜羊膜炎的研究结果大相径庭，尽管如此，CRP仍作为常用的绒毛膜羊膜炎的早期诊断指标。为了评价CRP用于未足月胎膜早破的患者绒毛膜羊膜炎诊断的准确性，研究者检索MEDLINE (1966–2006), EMBASE (1974–2006), PubMed and the Cochrane Library (2005)的研究以及主要研究和综述的参考文献，选择C反应蛋白用于未足月胎膜早破的患者绒毛膜羊膜炎诊断方法学质量高的研究，计算阳性和阴性似然比(LR) 和诊断比值比。结果显示：有8个主要研究包含610例患者被纳入。各研究之间阳性和阴性似然比(LR) 和诊断比值比有很大变异，由于可信区间宽，说明缺乏精确性。其中3项研究显示CRP是一种用于诊断绒毛膜羊膜炎有效的工具(DOR范围 4.2 --191.6)，尽管其中之一认为CRP阈值更高。另外5项研究得出相反的结论(DOR 范围1.4-- 17.7)。没有明显证据支持CRP在绒毛膜羊膜炎的早期诊断中的应用。需要更进一步的研究确定这一方法的诊断精确性。
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作者:admin@医学,生命科学 2011-02-20 05:12
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