CAJ | 학술논문

目的：探讨脑脊液和外周血T细胞酶联免疫斑点法（T-SPOT．TB）检测在结核性脑膜炎中的诊断价值。方法检索1990年1月至2013年10月PubMed、EMBASE等数据库，收集以T-SPOT．TB法诊断结核性脑膜炎的文献。由两位研究者独立筛选文献，提取资料，质量评价，以 Meta-Disc 1．4软件进行 Meta分析。结果共纳入8篇文献，425个病例，结核性脑膜炎232例。外周血组合并灵敏度为80％（95％CI：0．74～0．85），合并特异度为74％（95％CI：0．67～0．80），SROC 曲线下面积为0．8587；诊断比值比为15．50。脑脊液组合并灵敏度为76％（95％CI：0．70～0．82），合并特异度为83％（95％CI：0．77～0．88）， SROC曲线下面积为0．8927；合并诊断比值比为22．62。结论采用 T-SPOT．TB法有助于提高结核性脑膜炎的诊断率。脑脊液T-SPOT．TB诊断准确性可能高于外周血组。
목적：탐토뇌척액화외주혈T세포매련면역반점법（T-SPOT．TB）검측재결핵성뇌막염중적진단개치。방법검색1990년1월지2013년10월PubMed、EMBASE등수거고，수집이T-SPOT．TB법진단결핵성뇌막염적문헌。유량위연구자독립사선문헌，제취자료，질량평개，이 Meta-Disc 1．4연건진행 Meta분석。결과공납입8편문헌，425개병례，결핵성뇌막염232례。외주혈조합병령민도위80％（95％CI：0．74～0．85），합병특이도위74％（95％CI：0．67～0．80），SROC 곡선하면적위0．8587；진단비치비위15．50。뇌척액조합병령민도위76％（95％CI：0．70～0．82），합병특이도위83％（95％CI：0．77～0．88）， SROC곡선하면적위0．8927；합병진단비치비위22．62。결론채용 T-SPOT．TB법유조우제고결핵성뇌막염적진단솔。뇌척액T-SPOT．TB진단준학성가능고우외주혈조。
Objective To investigate the diagnostic value of the T-SPOT.TB test for diagnosing tuberculous meningitis(TBM) by meta-analysis.Methods A systematic retrieval from the databases of PubMed,EMBASE,etc.was performed.The literature on the T-SPOT.TB test for diagnosing TBM was collected.Two reviewers independently screened the literature,extracted the data and judged the quality.The meta analysis was conducted by the Meta-Disc 1.4 software.Results 8 articles were included,involving 425 patients including 232 cases of TBM.In the peripheral blood group,the combined sensitivity was 80%(95%CI:0.74-0.85),the combined specificity was 74%(95%CI:0.67-0.80),the area under the curve(AUC)of summary receiver operating characteristic (SROC)was 0.858 7;the diagnostic odds ratio(DOR)was 15.50.In the CSF group,the combined sensitivity was 76%(95%CI:0.70-0.82),the combined specificity was 83%(95%CI:0.77-0.88),AUC was 0.892 7;DOR was 22.62.Conclusion Adopting the T-SPOT.TB test conduces to increase the diagnostic rate of TBM.The diagnostic accuracy of the T-SPOT.TB test for CSF may be higher than that for peripheral blood.