Diagnostic and prognostic value of Ang-2 in ARDS: a systemic review and meta-analysis.

IF 2.9 3区医学 Q2 RESPIRATORY SYSTEM

Expert Review of Respiratory Medicine Pub Date : 2023-07-01 Epub Date: 2023-07-04 DOI:10.1080/17476348.2023.2230883

Qianglin Zeng, Gui Huang, Shanna Li, Fuqiang Wen

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引用次数: 1

Abstract

Background: To investigate the diagnostic and prognostic value of angiopoietin-2 (Ang-2) for acute respiratory distress syndrome (ARDS).

Methods: Seven databases (4 English and 3 Chinese databases) were searched, the quality was evaluated by QUADAS-2 and GRADE profile. The bivariate model was employed to combine area under the curve (AUC), pooled sensitivity (pSEN) and pooled specificity (pSPE), the Fagan's nomogram was employed for evaluating clinical utility. This study was registered in PROSPERO (NO.CRD42022371488).

Results: 18 eligible studies comprising 27 datasets (12 diagnostic and 15 prognostic datasets) were included for meta-analysis. For diagnostic analysis, Ang-2 yielded an AUC of 0.82, with a pSEN of 0.78 and a pSPE of 0.74; in clinical utility analysis, a pretest probability of 50% regulated the post probability positive (PPP) of 75% and the post probability negative (PPN) of 23%. In prognostic analysis, Ang-2 yielded an AUC of 0.83, with a pSEN of 0.69, a pSPE of 0.81, and good clinical utility (a pretest probability of 50% regulated the PPP of 79% and the PPN of 28%). Heterogeneity existed in both diagnostic and prognostic analysis.

Conclusions: Ang-2 demonstrates promising diagnostic and prognostic capabilities as a noninvasive circulating biomarker for ARDS, especially in the Chinese population. It is advisable to dynamically monitor Ang-2 in critically ill patients both suspected and with confirmed ARDS.

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Ang-2在ARDS中的诊断和预后价值：一项系统综述和荟萃分析。

背景：探讨血管生成素-2（Ang-2）对急性呼吸窘迫综合征（ARDS）的诊断和预后价值。采用双变量模型结合曲线下面积（AUC）、合并灵敏度（pSEN）和合并特异性（pSPE），采用Fagan列线图评估临床效用。本研究在PROSPERO（编号CRD42022371488）上注册。结果：纳入了18项符合条件的研究，包括27个数据集（12个诊断数据集和15个预后数据集）进行荟萃分析。对于诊断分析，Ang-2的AUC为0.82，pSEN为0.78，pSPE为0.74；在临床效用分析中，50%的前测概率调节了75%的后概率阳性（PPP）和23%的后概率阴性（PPN）。在预后分析中，Ang-2的AUC为0.83，pSEN为0.69，pSPE为0.81，具有良好的临床实用性（50%的预测试概率调节了79%的PPP和28%的PPN）。诊断和预后分析均存在异质性。结论：Ang-2作为ARDS的无创循环生物标志物，尤其是在中国人群中，具有良好的诊断和预后能力。在疑似和确诊ARDS的危重患者中动态监测Ang-2是可取的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Respiratory Medicine RESPIRATORY SYSTEM-

CiteScore

6.80

自引率

2.60%

发文量

期刊介绍： Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity