Analysis And Application Of Diagnostic Value Of Novel Inflammatory Marker Heparin-binding Protein In Infectious Diseases

Objective: To analyze the application value of heparin-binding protein(HBP)in the diagnosis of bacterial infectious diseases.To observe the expression level of HBP in bacterial infectious community acquired pneumonia,and to explore the clinical value of HBP quantitative detection in the diagnosis of bacterial infectious CAP.To compare the diagnostic performance and the performance of assessment the severity of bacterially infectious CAP with HBP,procalcitonin(PCT)and C-reactive protein(CRP)in.Method: 1.We searched pubmed,cochrane library,embase,CNKI,Network,Wanfang database and VIP database to collect diagnostic tests for HBP diagnosis of bacterial infectious diseases,using the QUADAS-2 tool for the included literature quality analysis.Meta-analysis of the included literature was performed using MetaDisc1.4 and Stata12.0 software.2.We collected 63 healthy volunteers and 109 patients with bacterial infectious CAP,and 86 patients with non-bacterial infectious CAP and tested their HBP,PCT and CRP levels.Compare the Statistics difference and the level in serum of healthy volunteers,non-bacterial infectious CAP and bacterial infectious CAP;we evaluated risk stratification of patients by CRUB-65 score,and compare the value of to assess disease severity,draw ROC curve and calculate the area under the curve,find the best cut-off value,analyze and compare sensitivity and specificity of the three indicators in the diagnosis of CAP.Results:1.Meta-analysis showed that the sensitivity and specificity of HBP in the diagnosis of bacterial infectious diseases were 0.80(95% CI: 0.78-0.82)and 0.83(95%CI: 0.80-0.85),respectively;the combined DOR was 26.14(95% CI: 13.43-50.88),the combined positive likelihood ratio was 5.34(95% CI: 3.39-8.40),the combined negative likelihood ratio was 0.24(95% CI: 0.19-0.30),and the area under the combined ROC curve was 0.89.(95% CI: 0.85-0.91).2.The experimental results showed that the serum HBP levels of healthy control group,non-bacterial infectious CAP and bacterial infectious CAP were 8.90,14.90,54.35 ng/ ml respectively.The difference was statistically significant.The three groups of PCT were 0.17,0.23,1.39 ng/ml respectively,and the difference was statistically significant.The three groups of CRP were 1.70,29.14,and 72.19 mg/L respectively,and the difference was statistically significant.3.In assessing the severity of the disease,the risk stratification was grouped according to theCRUB-65 score.The HBP level in the high-risk group was significantly higher than that in the intermediate-risk group(P=0.027)and the low-risk group(P<0.001).The difference was statistically significant.The level of HBP in the moderate risk group was significantly higher than that in the low risk group(P=0.020).The PCT level in the high-risk group was significantly higher than that in the low-risk group and the intermediate-risk group(P<0.001,P=0.015).There was no significant difference in PCT level in the low-risk group and the intermediate-risk group(P=0.109);the CRP level in the high-risk group was significantly higher than that in the low-risk group(P<0.001),while there was no difference between the middle-risk group and the high-risk group(P=0.056),and the difference in the low-risk group and the intermediate-risk group was not statistically significant(P=0.492).4.The ROC curve was drawn.The area under the HBP horizontal curve was 0.906(95% CI: 0.865-0.948),and when the HBP level reached 26.22 ng/ml,the sensitivity and specificity of the diagnosis of bacterial infectious pneumonia were 90.8%.And 85.2%.The area under the PCT horizontal curve was 0.808(95% CI: 0.746-0.870),and when the PCT level reached 0.84 ng/ml,the sensitivity and specificity for the diagnosis of bacterial infectious CAP were 75.2% and83.9%,respectively.The area under the CRP level curve was 0.718(95% CI:0.645-0.791),and when the CRP level reached 31.73 mg/L,the sensitivity and specificity of the diagnosis of bacterial infectious CAP were 78.9% and 74.5%,respectively.Conclusion: 1.Meta-analysis found that serum HBP has a high diagnostic value and good sensitivity and specificity when used for the diagnosis of bacterial infectious diseases;2.Through the detection of clinical specimens,serum HBP,PCT and CRP can be used as indicators for the detection of bacterial infectious CAP.The sensitivity,specificity and diagnostic effect of HBP for diagnosing bacterial infectious CAP are better than PCT and CRP.3.The level of HBP will increase with the severity of the patient’s condition,and the evaluation of HBP in the severity of the disease will be better.Therefore,it can be used as a basic early predictor of sepsis,and has a certain value of disease development and prognosis evaluation。...