半胱氨酸蛋白酶抑制剂C在脓毒症患者急性肾损伤中的诊断价值：系统综述和荟萃分析
Diagnostic value of cystatin C in acute kidney injury among patients with sepsis: a systematic review and meta-analysis.
摘要(中文译文)
本研究旨在通过荟萃分析评估胱抑素C（CysC）对脓毒症患者急性肾损伤（AKI）早期检测的诊断价值。使用预设检索词从电子数据库中系统检索相关研究，检索词包括“脓毒症”“急性肾损伤”和“诊断”。采用诊断准确性研究质量评价工具-2（QUADAS-2）评估研究质量。使用Stata 12.0软件进行随机效应荟萃分析，计算合并效应估计值及相应的95%置信区间（CI）。随后构建综合受试者工作特征（SROC）曲线，并计算曲线下面积（AUC）以评估总体诊断性能。共纳入17项关于胱抑素C诊断检测的研究，并应用随机效应模型进行荟萃分析。结果表明，胱抑素C对脓毒症相关急性肾损伤（SA-AKI）表现出良好的诊断性能，AUC为0.88，灵敏度为0.81，特异度为0.82。亚组分析进一步显示，基于Sepsis 3.0标准的研究具有更高的特异度和诊断比值比（DOR），且异质性降低。此外，胱抑素C与其他生物标志物联合进一步提高了诊断准确性。总体而言，这些发现提示胱抑素C是SA-AKI早期诊断的有前景的生物标志物。本荟萃分析表明，胱抑素C对SA-AKI的早期诊断具有相当大的价值。尽管纳入研究间仍存在异质性，但总体证据支持其在临床实践中的潜在适用性。https://www.crd.york.ac.uk/PROSPERO/view/CRD420251128608，标识符PROSPERO（CRD420251128608）。
Abstract
This study aimed to evaluate the diagnostic value of cystatin C (CysC) for the early detection of acute kidney injury (AKI) in patients with sepsis through a meta-analysis. Relevant studies were systematically retrieved from electronic databases using predefined search terms, including "sepsis," "acute kidney injury," and "diagnosis." Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A random-effects meta-analysis was conducted using Stata 12.0 software to calculate pooled effect estimates and corresponding 95% confidence intervals (CIs). Subsequently, a summary receiver operating characteristic (SROC) curve was constructed, and the area under the curve (AUC) was calculated to evaluate overall diagnostic performance. A total of 17 studies on cystatin C for diagnostic testing were included, and a random-effects model was applied for meta-analysis. The results indicated that cystatin C exhibited good diagnostic performance for sepsis-associated acute kidney injury (SA-AKI), with an AUC of 0.88, sensitivity of 0.81, and specificity of 0.82. Subgroup analyses further demonstrated that studies based on the Sepsis 3.0 criteria showed higher specificity and diagnostic odds ratio (DOR), along with reduced heterogeneity. In addition, the combination of cystatin C with other biomarkers further improved diagnostic accuracy. Overall, these findings suggest that cystatin C is a promising biomarker for the early diagnosis of SA-AKI. This meta-analysis demonstrates that cystatin C has considerable value for the early diagnosis of SA-AKI. Although heterogeneity among included studies remains, the overall evidence supports its potential applicability in clinical practice. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251128608, identifier PROSPERO (CRD420251128608).
如何引用
AMA
Luping Cheng, Bo Zhang, Xia Hu, Wenxin Wang, Hong Wan, Jun Liao, et al. Diagnostic value of cystatin C in acute kidney injury among patients with sepsis: a systematic review and meta-analysis.. Frontiers in medicine. 2026; doi:10.3389/fmed.2026.1769556.
APA
Luping Cheng, Bo Zhang, Xia Hu, Wenxin Wang, Hong Wan, Jun Liao, et al (2026). Diagnostic value of cystatin C in acute kidney injury among patients with sepsis: a systematic review and meta-analysis.. Frontiers in medicine. https://doi.org/10.3389/fmed.2026.1769556
GB/T 7714
Luping Cheng, Bo Zhang, Xia Hu, Wenxin Wang, Hong Wan, Jun Liao, et al. Diagnostic value of cystatin C in acute kidney injury among patients with sepsis: a systematic review and meta-analysis.[J]. Frontiers in medicine, 2026 doi:10.3389/fmed.2026.1769556.
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