【摘要】 目的探讨细胞角蛋白18的切割片段M30和M65对非酒精性脂肪性肝炎(NASH)的诊断价值。方法计算机系统性检索PubMed、EMbase、Cochrane网上图书馆和中国知网及万方数据库的文献,检索时间为自建库至2020年10月,对收集的文献进行整理及质量评价后,采用Meta-Disc1.4软件和Stata 16.0软件统计分析。结果本文最终纳入17篇文献,M30相关文献15篇,M65相关文献7篇,总样本量1301例。M30诊断NASH总敏感度和特异性分别为0.646(95%CI:0.606～0.684)和0.772(95%CI:0.736～0.806)。M65诊断NASH总敏感度和特异性分别为0.698(95%CI:0.639～0.752)和0.756(95%CI:0.699～0.807)。M30的集成受试者操作特征曲线法(sROC)的曲线下面积为0.8264;M65的sROC曲线下面积为0.7899。结论细胞角蛋白18的切割片段M30和M65对临床诊断NASH有一定意义,但是单独诊断或排除NASH效果中等,需要结合其他检查联合诊断。更多还原

【Abstract】 Objective To evaluate the diagnostic value of cytokeratin 18 fragments M30 and M65 in non-alcoholic steatohepatitis(NASH). Methods Literatures from PubMed, EMbase, Cochrane online Library, CNKI and Wanfang database were systematically searched by computer. The retrieval time was from inception to October 2020. After sorting out the collected literature and evaluating its quality, Meta-Disc1.4 software and Stata 16.0 software were used for statistical analysis. Results This paper included 17 literatures, 15 literatures related to M30 and seven literatures related to M65, with a total sample size of 1301. The total sensitivity and specificity of M30 for NASH were 0.646(95%CI:0.606-0.684) and 0.772(95%CI: 0.736-0.806), respectively. The total sensitivity and specificity of M65 for NASH were 0.698(95%CI: 0.639-0.752) and 0.756(95%CI: 0.699-0.807), respectively. The area under curve of the summary receiver operator characteristic method(sROC) of M30 was 0.8264. The area under the sROC curve of M65 was 0.7899.Conclusion Cytokeratin 18 fragments M30 and M65 have certain significance for clinical diagnosis of NASH, but the effect of diagnosis alone or exclusion of NASH is moderate, and the diagnosis should be combined with other tests.更多还原