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目的:系统评价microRNA-499(miRNA-499)在急性心肌梗死(AMI)患者诊断中的临床价值。方法:计算机检索Cochrane Library Medline、Embase、Pubmed、万方数据库、维普中国科技期刊数据库、中国生物医学文献数据库、中国知网数据库有关miRNA-499诊断AMI的文献。采用MetaDisc1.4软件进行系统评价。评价指标为总体灵敏度、特异度、阳性似然比、阴性似然比、诊断优势比以及受试者工作特征曲线(SROC)下面积。结果:共纳入15篇文献,合计AMI患者1 943例,健康者1 867例。Meta分析结果显示,miRNA-499诊断AMI的总体灵敏度为0.83(95%CI:0.82~0.85);特异度为0.79(95%CI:0.77~0.80);阳性似然比为5.73(95%CI:3.74~8.78);阴性似然比为0.21(95%CI:0.16~0.29);诊断优势比为26.29(95%CI:15.24~45.34)。SROC曲线下面积为0.881 8。结论:miRNA-499对AMI诊断具有较高的灵敏度和特异度,有较强的诊断价值。
OBJECTIVE: To systematically evaluate the clinical value of microRNA-499 (miRNA-499) in the diagnosis of patients with acute myocardial infarction (AMI). Methods: The literature of miRNA-499 for the diagnosis of AMI was searched by computer in Cochrane Library Medline, Embase, Pubmed, Wanfang Database, VIP Chinese Science and Technology Database, China Biomedical Literature Database and CNKI Database. MetaDisc 1.4 software was used for systematic reviews. The evaluation indicators were overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the receiver operating characteristic curve (SROC). Results: A total of 15 articles were included, including 1 943 AMI patients and 1867 healthy controls. The overall sensitivity of miRNA-499 in the diagnosis of AMI was 0.83 (95% CI: 0.82-0.85); the specificity was 0.79 (95% CI: 0.77-0.80); the positive likelihood ratio was 5.73 (95% CI: 3.74 ~ 8.78). The negative likelihood ratio was 0.21 (95% CI: 0.16-0.29). The diagnostic odds ratio was 26.29 (95% CI: 15.24-45.34). The area under the SROC curve is 0.881 8. Conclusion: miRNA-499 has high sensitivity and specificity for the diagnosis of AMI and has strong diagnostic value.