中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2014年
10期
616-621
,共6页
汪月娥%张天嵩%范清琪%王虹
汪月娥%張天嵩%範清琪%王虹
왕월아%장천숭%범청기%왕홍
瞬时弹性成像%肝硬化%肝炎,丙型,慢性%Meta分析%诊断
瞬時彈性成像%肝硬化%肝炎,丙型,慢性%Meta分析%診斷
순시탄성성상%간경화%간염,병형,만성%Meta분석%진단
Transient elasography%Liver cirrhosis%Hepatitis C,chronic%Meta-analysis%Diagnosis
目的 系统评价肝脏瞬时弹性成像技术(TE)对慢性丙型肝炎肝纤维化和肝硬化的诊断价值.方法 通过FMJS西文生物医学期刊文献数据库查找有关TE在慢性丙型肝炎肝纤维化和肝硬化的预测诊断方面的全文文献(2003年1月1日至2013年8月31日),全文通道有Pubmed、EBSCO、Elsevier Science、Ovid、Wiley等.采用诊断性试验准确性质量评价工具(QUADAS)进行方法学质量评估,采用Stata统计软件拟合双变量混合效应模型评价TE诊断慢性丙型肝炎肝纤维化和肝硬化的准确性.结果 共纳入27篇文献5 937例受试者.拟合双变量结果显示,TE诊断明显肝纤维化的灵敏度、特异度、阳性似然比、阴性似然比、诊断比数比、受试者工作特征曲线下面积(AUROC)分别为0.75(95％CI:0.70～0.80)、0.84(95％CI:0.78～0.88)、4.70(95％CI:3.60～6.20)、0.29(95％CI:0.24～0.36)、16.00(95％CI:12.00～22.00)、0.86(95％CI:0.83～0.89);TE诊断肝硬化的灵敏度、特异度、阳性似然比、阴性似然比、诊断比数比、AUROC分别为0.86 (95％ CI:0.82～0.89)、0.89(95％CI:0.86～0.92)、8.10(95％CI:6.30～10.40)、0.16(95％CI:0.12～0.20)、51.00(95％CI:35.00～76.00)、0.94(95％CI:0.91～0.96).结论 TE对慢性丙型肝炎肝硬化的诊断价值较好,但对明显肝纤维化诊断价值不高,需要更多高质量的研究证实.
目的 繫統評價肝髒瞬時彈性成像技術(TE)對慢性丙型肝炎肝纖維化和肝硬化的診斷價值.方法 通過FMJS西文生物醫學期刊文獻數據庫查找有關TE在慢性丙型肝炎肝纖維化和肝硬化的預測診斷方麵的全文文獻(2003年1月1日至2013年8月31日),全文通道有Pubmed、EBSCO、Elsevier Science、Ovid、Wiley等.採用診斷性試驗準確性質量評價工具(QUADAS)進行方法學質量評估,採用Stata統計軟件擬閤雙變量混閤效應模型評價TE診斷慢性丙型肝炎肝纖維化和肝硬化的準確性.結果 共納入27篇文獻5 937例受試者.擬閤雙變量結果顯示,TE診斷明顯肝纖維化的靈敏度、特異度、暘性似然比、陰性似然比、診斷比數比、受試者工作特徵麯線下麵積(AUROC)分彆為0.75(95％CI:0.70～0.80)、0.84(95％CI:0.78～0.88)、4.70(95％CI:3.60～6.20)、0.29(95％CI:0.24～0.36)、16.00(95％CI:12.00～22.00)、0.86(95％CI:0.83～0.89);TE診斷肝硬化的靈敏度、特異度、暘性似然比、陰性似然比、診斷比數比、AUROC分彆為0.86 (95％ CI:0.82～0.89)、0.89(95％CI:0.86～0.92)、8.10(95％CI:6.30～10.40)、0.16(95％CI:0.12～0.20)、51.00(95％CI:35.00～76.00)、0.94(95％CI:0.91～0.96).結論 TE對慢性丙型肝炎肝硬化的診斷價值較好,但對明顯肝纖維化診斷價值不高,需要更多高質量的研究證實.
목적 계통평개간장순시탄성성상기술(TE)대만성병형간염간섬유화화간경화적진단개치.방법 통과FMJS서문생물의학기간문헌수거고사조유관TE재만성병형간염간섬유화화간경화적예측진단방면적전문문헌(2003년1월1일지2013년8월31일),전문통도유Pubmed、EBSCO、Elsevier Science、Ovid、Wiley등.채용진단성시험준학성질량평개공구(QUADAS)진행방법학질량평고,채용Stata통계연건의합쌍변량혼합효응모형평개TE진단만성병형간염간섬유화화간경화적준학성.결과 공납입27편문헌5 937례수시자.의합쌍변량결과현시,TE진단명현간섬유화적령민도、특이도、양성사연비、음성사연비、진단비수비、수시자공작특정곡선하면적(AUROC)분별위0.75(95％CI:0.70～0.80)、0.84(95％CI:0.78～0.88)、4.70(95％CI:3.60～6.20)、0.29(95％CI:0.24～0.36)、16.00(95％CI:12.00～22.00)、0.86(95％CI:0.83～0.89);TE진단간경화적령민도、특이도、양성사연비、음성사연비、진단비수비、AUROC분별위0.86 (95％ CI:0.82～0.89)、0.89(95％CI:0.86～0.92)、8.10(95％CI:6.30～10.40)、0.16(95％CI:0.12～0.20)、51.00(95％CI:35.00～76.00)、0.94(95％CI:0.91～0.96).결론 TE대만성병형간염간경화적진단개치교호,단대명현간섬유화진단개치불고,수요경다고질량적연구증실.
Objective To assess the diagnostic value of transient elastography (TE) for the staging of liver fibrosis and cirrhosis in patients with chronic hepatitis C.Methods Systematic and comprehensive literatures related to diagnosis value of TE for chronic hepatitis C were searched in FMJS biomedical database (from Jan.1st,2003 to Aug.31st,2013).Full texts were obtained from PubMed,EBSCO,Elsevier Science,Ovid,Wiley database.The quality of the studies was rated with quality assessment of diagnostic accuracy studies (QUADAS).The accuracy of TE in diagnosing liver fibrosis and cirrhosis were assessed by Stata software bivariate mixed effects model.Results Twenty seven eligible studies which included 5 937 subjects were enrolled.The meta-analysis of fitting the bivariate mixed effects model showed that the pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio,and the area under curve (AUC) of summary receiver operating characteristic (SROC) for liver fibrosis were 0.75(95％CI:0.70-0.80),0.84(95％CI:0.78-0.88),4.70(95％CI:3.60-6.20),0.29(95％CI:0.24-0.36),16.00(95％CI:12.00-22.00) and 0.86(95％CI:0.83-0.89),respectively.And those for cirrhosis were 0.86(95％CI:0.82-0.89),0.89(95％CI:0.86-0.92),8.10(95％CI:6.30-10.40),0.16(95％CI:0.12-0.20),51.00(95％CI:35.00-76.00) and 0.94(95％CI:0.91-0.96),respectively.Conclusions TE shows better diagnostic accuracy for cirrhosis than for significant fibrosis in patients with chronic hepatitis C.More high quality trials are required to further confirm this finding.
