目的　评价尿白介素18（IL-18）用于早期诊断儿童急性肾损伤（AKI）的价值。方法　计算机检索Medline、 EMBASE、Cochrane图书馆、PubMed、Web of Science、Google Scholar、中国知网、维普及万方数据库等，检索时间为从建 库至2018年3月，获得尿IL-18诊断儿童AKI的文献。采用诊断准确性研究的质量评估方法2（QUADAS-2）对纳入文献进 行质量评价，应用Meta-Disc 1.4和STATA 12.0软件进行数据分析。结果　共纳入9项研究，包括1 214例患儿。Meta分析 结果显示，尿IL-18诊断儿童AKI的合并灵敏度为0.74 （95%CI: 0.69~0.79），合并特异度为0.66 （95%CI:0.63~0.69）， 合并阳性似然比为2.30（95%CI:1.80~2.92），合并阴性似然比为0.42（95%CI:0.31~0.56），合并诊断比值比为6.50 （95%CI:4.20~10.07），综合受试者工作特征曲线下面积为0.779（S.E.=0.025）。 结论　尿IL-18是早期预测儿童AKI的 有价值的生物标志物，其诊断准确性中等。

Objective　To explore the value of urinary interleukin 18 (IL-18) in the early diagnosis of acute kidney injury (AKI) in children. Method　Medline, EMBASE, Cochrane Library, PubMed, Web of Science, Google Scholar, China National Knowledge Infrastructure, VIP and WanFang Database were searched and retrieved. The literature of urinary IL-18 for the diagnosis of AKI in children were obtained from inception to March 2018. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used to evaluate the quality of included literature. Meta-Disc 1.4 and STATA 12.0 software were used to analyze the data. Results　A total of 9 studies were included, including 1214 children. Across all settings, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for urinary IL-18 level to predict AKI were 0.74 (95%CI: 0.69~0.79), 0.66 (95%CI: 0.63~0.69), 2.30 (95%CI: 1.80~2.92), 0.42 (95%CI:0.31~0.56) and 6.50(95%CI: 4.20~10.07), respectively, and the area under the summary receiver operating characteristic curve was 0.779 (S.E.=0.025). Conclusion　Urinary IL-18 is a valuable biomarker for the early prediction of childhood AKI with moderate diagnostic accuracy.