CAJ | 학술논문

目的对国内外发表的糖缺失性转铁蛋白（CDT ）或其相对值（％ CDT ）诊断酒精性肝病（ALD ）的研究进行系统评价，为酒精性肝病的临床诊断提供参考依据。方法计算机检索 PubMed、EMBASE、维普、万方、中国期刊全文数据库等文献数据库。按照纳入和排除标准对所检索的文献进行筛选并提取研究中相关的数据，采用M etaDiSc1．4软件对研究进行评价，对诊断的准确性进行 M eta分析。结果符合纳入标准的研究共6篇，其中ALD组259例，非酒精性肝病组（NALD）组308例，健康人群组262例。Meta分析结果显示：ALD与NALD组鉴别诊断中，其合并敏感度（Se）、特异度（Sp）、阳性似然比（＋ LR）、阴性似然比（-LR）、诊断优势比（DOR）和汇总受试者工作特征曲线（SROC）曲线下面积分别为：72％、82％、4．20、0．34、15．46、0．8667；ALD与健康对照组鉴别中，其合并Se、Sp、＋LR、-LR、DOR和SROC曲线下面分别为：73％、89％、5．62、0．35、27．76、0．9085。结论临床应用CDT或％ CDT对ALD进行排除诊断时准确性性较高，但运用在ALD的诊断中需要结合患者的饮酒史进行综合评价。上述研究结果还需要更多设计科学、严谨的临床试验验证。
목적대국내외발표적당결실성전철단백（CDT ）혹기상대치（％ CDT ）진단주정성간병（ALD ）적연구진행계통평개，위주정성간병적림상진단제공삼고의거。방법계산궤검색 PubMed、EMBASE、유보、만방、중국기간전문수거고등문헌수거고。안조납입화배제표준대소검색적문헌진행사선병제취연구중상관적수거，채용M etaDiSc1．4연건대연구진행평개，대진단적준학성진행 M eta분석。결과부합납입표준적연구공6편，기중ALD조259례，비주정성간병조（NALD）조308례，건강인군조262례。Meta분석결과현시：ALD여NALD조감별진단중，기합병민감도（Se）、특이도（Sp）、양성사연비（＋ LR）、음성사연비（-LR）、진단우세비（DOR）화회총수시자공작특정곡선（SROC）곡선하면적분별위：72％、82％、4．20、0．34、15．46、0．8667；ALD여건강대조조감별중，기합병Se、Sp、＋LR、-LR、DOR화SROC곡선하면분별위：73％、89％、5．62、0．35、27．76、0．9085。결론림상응용CDT혹％ CDT대ALD진행배제진단시준학성성교고，단운용재ALD적진단중수요결합환자적음주사진행종합평개。상술연구결과환수요경다설계과학、엄근적림상시험험증。
Objective To systematically assess the performance of carbohydrate deficient transferrin (CDT ) or its relative value (% CDT ) in the diagnosis of alcoholic liver disease (ALD ) .Methods Databases , including PubMed ,EMBASE ,CNKI ,WanFang and CSJD ,were retrieved for related articles about the application fo CDT in the diagnosis for ALD .MetaDisc1 .4 software was used to assess accuracy of it .Results Six studies met the eligibili-ty criteria and were included ,including 259 cases for ALD group ,308 cases for NALD group and 262 cases for nor-mal group .Meta analysis indicated that ,for the differential diagnosis between ALD group and NALD group ,the summary values of sensitivity (Se) ,specificity (Sp) ,positive likelihood ratio (+LR) ,negative likelihood ratio (-LR) , diagnostic odds ratio(DOR) and area under summary receiver operating curve(SROC AUC) were 72% ,82% ,4 .20 , 0 .34 ,15 .46 and 0 .866 7 ,and for the differential diagnosis between ALD group and normal group ,the summary values of Se ,Sp ,+LR ,-LR ,DOR and SROC AUC were 73% ,89% ,5 .62 ,0 .35 ,27 .76 and 0 .908 5 .Conclu-sion CDT or % CDT might be accurate for the exclusive diagnosis of ALD ,but should be combined with drinking history for the diagnosis of ALD .The results might need to be studied further in future .