中国免疫学杂志
中國免疫學雜誌
중국면역학잡지
Chinese Journal of Immunology
2015年
11期
1515-1519
,共5页
邱杰山%李青华%沈水娟%王时敏%朱晓玲
邱傑山%李青華%瀋水娟%王時敏%硃曉玲
구걸산%리청화%침수연%왕시민%주효령
抗-PLA2 R抗体%特发性膜性肾病%血清%meta分析
抗-PLA2 R抗體%特髮性膜性腎病%血清%meta分析
항-PLA2 R항체%특발성막성신병%혈청%meta분석
Anti-PLA2 R antibody%Ldiopathic membranous nephropathy%Serum%Meta-analysis
目的：探讨血清抗-PLA2 R抗体（ anti-PLA2 R）在特发性膜性肾病（ IMN）诊断中的价值。方法：检索PubMed、Elsevier、Springer、中国期刊全文数据库、中国科技期刊数据库、万方数字化期刊全文数据库等数据库中2009年1月至2013年12月国内外公开发表的关于血清anti-PLA2 R诊断特发性膜性肾病的相关文献，根据纳入和排除标准筛选文献并提取数据，采用诊断精确性研究的质量评估方法（ QUADAS）评价文献质量，通过Meta-Disc和Stata软件进行Meta分析。通过汇总后的敏感度、特异度、似然比及汇总受试者工作曲线（ ROC）综合评价血清anti-PLA2 R对IMN的诊断价值。采用依次减少一篇文献的方法进行敏感性分析，通过Egger漏斗图检验文献发表偏倚。结果：共筛选出7篇文献。累计病例967例，其中IMN患者454例，对照组513例。异质性检验提示不存在阈值效应引起的异质性（Spearman相关系数为0.107，P＝0.819），但存在非阈值效应引起的异质性（Cochrane-Q为16.89，P＝0.0097）。采用随机效应模型合并诊断指标。合并后的灵敏度为69％，95％CI：0.65～0.73，特异度为98％，95％CI：0.96～0.99。汇总阳性似然比16.37，95％CI：4.06～65.95，汇总阴性似然比0.32，95％CI：0.24～0.43。 SROC曲线显示AUC为0.8540，Q*指数为0.7850。敏感性分析显示本研究稳定可信，Egger漏斗图显示无明显发表偏倚。结论：血清anti-PLA2 R对诊断IMN具有重要的临床价值。
目的：探討血清抗-PLA2 R抗體（ anti-PLA2 R）在特髮性膜性腎病（ IMN）診斷中的價值。方法：檢索PubMed、Elsevier、Springer、中國期刊全文數據庫、中國科技期刊數據庫、萬方數字化期刊全文數據庫等數據庫中2009年1月至2013年12月國內外公開髮錶的關于血清anti-PLA2 R診斷特髮性膜性腎病的相關文獻，根據納入和排除標準篩選文獻併提取數據，採用診斷精確性研究的質量評估方法（ QUADAS）評價文獻質量，通過Meta-Disc和Stata軟件進行Meta分析。通過彙總後的敏感度、特異度、似然比及彙總受試者工作麯線（ ROC）綜閤評價血清anti-PLA2 R對IMN的診斷價值。採用依次減少一篇文獻的方法進行敏感性分析，通過Egger漏鬥圖檢驗文獻髮錶偏倚。結果：共篩選齣7篇文獻。纍計病例967例，其中IMN患者454例，對照組513例。異質性檢驗提示不存在閾值效應引起的異質性（Spearman相關繫數為0.107，P＝0.819），但存在非閾值效應引起的異質性（Cochrane-Q為16.89，P＝0.0097）。採用隨機效應模型閤併診斷指標。閤併後的靈敏度為69％，95％CI：0.65～0.73，特異度為98％，95％CI：0.96～0.99。彙總暘性似然比16.37，95％CI：4.06～65.95，彙總陰性似然比0.32，95％CI：0.24～0.43。 SROC麯線顯示AUC為0.8540，Q*指數為0.7850。敏感性分析顯示本研究穩定可信，Egger漏鬥圖顯示無明顯髮錶偏倚。結論：血清anti-PLA2 R對診斷IMN具有重要的臨床價值。
목적：탐토혈청항-PLA2 R항체（ anti-PLA2 R）재특발성막성신병（ IMN）진단중적개치。방법：검색PubMed、Elsevier、Springer、중국기간전문수거고、중국과기기간수거고、만방수자화기간전문수거고등수거고중2009년1월지2013년12월국내외공개발표적관우혈청anti-PLA2 R진단특발성막성신병적상관문헌，근거납입화배제표준사선문헌병제취수거，채용진단정학성연구적질량평고방법（ QUADAS）평개문헌질량，통과Meta-Disc화Stata연건진행Meta분석。통과회총후적민감도、특이도、사연비급회총수시자공작곡선（ ROC）종합평개혈청anti-PLA2 R대IMN적진단개치。채용의차감소일편문헌적방법진행민감성분석，통과Egger루두도검험문헌발표편의。결과：공사선출7편문헌。루계병례967례，기중IMN환자454례，대조조513례。이질성검험제시불존재역치효응인기적이질성（Spearman상관계수위0.107，P＝0.819），단존재비역치효응인기적이질성（Cochrane-Q위16.89，P＝0.0097）。채용수궤효응모형합병진단지표。합병후적령민도위69％，95％CI：0.65～0.73，특이도위98％，95％CI：0.96～0.99。회총양성사연비16.37，95％CI：4.06～65.95，회총음성사연비0.32，95％CI：0.24～0.43。 SROC곡선현시AUC위0.8540，Q*지수위0.7850。민감성분석현시본연구은정가신，Egger루두도현시무명현발표편의。결론：혈청anti-PLA2 R대진단IMN구유중요적림상개치。
Objective:To investigate the value of serum anti-PLA2 R as a diagnostic marker of idiopathic membranous nephropathy( IMN).Methods:All available articles about serum anti-PLA2 R as a marker of IMN which were published at home and abroad from 2009.1 to 2013.12 were pooled from the databases of PubMed,Elsevier,Springer,CNKI,VIP and Wanfang database et al. The quality of the papers were evaluated by the quality assessment for studies of diagnostic accuracy studies( QUADAS).And then a meta-analysis was conducted by the statistical softwares of Meta-Disc and Stata.The diagnostic value of serum anti-PLA2 R in IMN was evaluated by the statistical indicators of pooled sensitivity, pooled specificity, pooled likelihood ratio and summary receiver operating characteristic curve( ROC curve).Sensitivity analysis was performed by reducing a paper in order,and publication bias was tested by Egger funnel plot.Results: Seven articles were selected to the meta-analysis according to the inclusion criteria and 967 cases were included in the study ( 454 IMN patients and 513 controls ).Heterogeneity test showed no heterogeneity threshold effect ( Spearman correlation coefficient was 0.107,P=0.819),but there was heterogeneity caused by non threshold effects(Cochrane-Q was 16.89,P=0.009 7).So random model was used to pool the effect size.The overall combined effect sizes:sensitivity was 69%,95%CI:0.65-0.73;specificity:98%,95%CI:0.96-0.99;pooled positive likelihood ratio 16.37,95%CI:4.06-65.95;pooled negative likelihood ratio 0.32,95%CI:0.24-0.43;AUC of SROC:0.854 0,Q*=0.785 0.Sensitivity analysis showed that this research was stable and reliable and Egger funnel plot showed little publication bias.Conclusion: Serum anti-PLA2 R is an useful biomarker to the diagnosis of IMN.
