CAJ | 학술논문

目的评价γ-干扰素释放试验( interferon-γrelease assays, IGRA)在结核分枝杆菌感染诊断中的应用价值。方法通过计算机检索中国生物医学文献数据库(CBM)、中国知网(CNKI)和万方数据库(1994年1月-2013年6月)获得IGRA诊断结核分枝杆菌感染的诊断性试验研究的中文文献。由两名研究者按照相同的检索策略独立进行文献筛选和数据提取,排除不符合纳入标准的文献后,应用Meta Disc 1.4软件进行数据分析。结果本研究共检索到符合要求的文献17项,共1799例结核患者和885例对照者纳入meta分析。结果显示IGRA诊断结核分枝杆菌感染敏感度为86%[95%可信区间(CI)：0.85~0.88],特异度为86%(95%CI：0.83~0.88)；阳性似然比为6.06(95%CI：4.76~7.70),阴性似然比为0.12(95%CI：0.09~0.18),诊断比数比为58.67(95%CI：35.37~97.31)。拟合SROC曲线下面积(area under the curve, AUC)为0.9457,Q*=0.8848。结论 IGRA诊断结核分枝杆菌感染有较高的敏感性和特异性,可作为临床快速诊断结核病的有效方法。
목적평개γ-간우소석방시험( interferon-γrelease assays, IGRA)재결핵분지간균감염진단중적응용개치。방법통과계산궤검색중국생물의학문헌수거고(CBM)、중국지망(CNKI)화만방수거고(1994년1월-2013년6월)획득IGRA진단결핵분지간균감염적진단성시험연구적중문문헌。유량명연구자안조상동적검색책략독립진행문헌사선화수거제취,배제불부합납입표준적문헌후,응용Meta Disc 1.4연건진행수거분석。결과본연구공검색도부합요구적문헌17항,공1799례결핵환자화885례대조자납입meta분석。결과현시IGRA진단결핵분지간균감염민감도위86%[95%가신구간(CI)：0.85~0.88],특이도위86%(95%CI：0.83~0.88)；양성사연비위6.06(95%CI：4.76~7.70),음성사연비위0.12(95%CI：0.09~0.18),진단비수비위58.67(95%CI：35.37~97.31)。의합SROC곡선하면적(area under the curve, AUC)위0.9457,Q*=0.8848。결론 IGRA진단결핵분지간균감염유교고적민감성화특이성,가작위림상쾌속진단결핵병적유효방법。
Objective To evaluate the application value of interferon-γrelease assays ( IGRA) in diagnosis of myco-bacterium tuberculosis infection. Methods All Chinese studies about IGRA in diagnosis of mycobacterium tuberculosis infec-tion during January 1994 and June 2013 were retrieved from CbmWin, CNKI and Wanfang databases. Two researchers a-chieved studies screening and data fetch independently, and then data analysis were conducted by meta-Disc1. 4 software after discrepancy studies were removed. Results Seventeen studies with 1799 patients and 885 controls were included in this stud-y. The results of meta-analysis showed that the sensitivity of mycobacterium tuberculosis was 86% [95% confidence interval (CI) :0. 85-0. 88];specificity was 86% (95% CI:0. 83-0. 88); positive likelihood ratio (LR) was 6. 06 (95% CI:4.76-7.70);negative LR was 0. 12 (95% CI: 0. 09 -0. 18) and diagnosis odds ratio (DOR) was 58. 67 (95% CI:35.37-97.31). Area under the curve (AUC) of fitting the summary receiver operating characteristic (SROC) was 0. 9457 and Q* =0. 8848. Conclusion Whole-blood interferon-γ release assays has good sensitivity and specificity in diagnosis of mycobacterium tuberculosis infection, and can be used as an effective method in clinical diagnosis of TB.