现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2015年
7期
972-976
,共5页
抗体,抗中性白细胞胞质%酵母菌,酿酒%敏感性与特异性%炎性肠疾病%Meta分析
抗體,抗中性白細胞胞質%酵母菌,釀酒%敏感性與特異性%炎性腸疾病%Meta分析
항체,항중성백세포포질%효모균,양주%민감성여특이성%염성장질병%Meta분석
Antibodies,antineutrophil cytoplasmic%Saccharomyces cerevisiae%Sensitivity and specificity%In-flammatory bowel disease%Meta-analysis
目的：通过meta分析评价抗中性粒细胞胞质抗体（ANCA）、抗酿酒酵母细胞抗体（ASCA）对成人炎症性肠病（IBD）亚组的诊断价值。方法通过国内外各大数据库检索ANCA、抗ASCA与成人溃疡性结肠炎、克罗恩病（CD）相关的文献，采用QUADAS—2量表评价纳入文献质量，利用meta—disc计算异质性及合并敏感度、特异度、阳性似然比、阴性似然比及诊断比值比，并绘制受试者工作曲线。结果按照纳入及排除标准共有13项独立研究入选meta分析，用meta—disc1.4软件联合ANCA诊断溃疡性结肠炎、ASCA诊断克罗恩病的总敏感度、特异度、阳性拟然比、阴性拟然比、诊断比值比、受试者工作曲线下面积分别为0.51、0.92、6.06、0.53、12.56、0.79、0.56、0.92、5.13、0.57、10.33、0.82。结论 ANCA、ASCA有利于IBD亚组的诊断，临床表现疑似的首诊患者可先行该检查，血清标志物阳性者给予早期治疗，阴性后再完善结肠镜检。该思路对增加依从性、疾病预后均具有重要意义。
目的：通過meta分析評價抗中性粒細胞胞質抗體（ANCA）、抗釀酒酵母細胞抗體（ASCA）對成人炎癥性腸病（IBD）亞組的診斷價值。方法通過國內外各大數據庫檢索ANCA、抗ASCA與成人潰瘍性結腸炎、剋囉恩病（CD）相關的文獻，採用QUADAS—2量錶評價納入文獻質量，利用meta—disc計算異質性及閤併敏感度、特異度、暘性似然比、陰性似然比及診斷比值比，併繪製受試者工作麯線。結果按照納入及排除標準共有13項獨立研究入選meta分析，用meta—disc1.4軟件聯閤ANCA診斷潰瘍性結腸炎、ASCA診斷剋囉恩病的總敏感度、特異度、暘性擬然比、陰性擬然比、診斷比值比、受試者工作麯線下麵積分彆為0.51、0.92、6.06、0.53、12.56、0.79、0.56、0.92、5.13、0.57、10.33、0.82。結論 ANCA、ASCA有利于IBD亞組的診斷，臨床錶現疑似的首診患者可先行該檢查，血清標誌物暘性者給予早期治療，陰性後再完善結腸鏡檢。該思路對增加依從性、疾病預後均具有重要意義。
목적：통과meta분석평개항중성립세포포질항체（ANCA）、항양주효모세포항체（ASCA）대성인염증성장병（IBD）아조적진단개치。방법통과국내외각대수거고검색ANCA、항ASCA여성인궤양성결장염、극라은병（CD）상관적문헌，채용QUADAS—2량표평개납입문헌질량，이용meta—disc계산이질성급합병민감도、특이도、양성사연비、음성사연비급진단비치비，병회제수시자공작곡선。결과안조납입급배제표준공유13항독립연구입선meta분석，용meta—disc1.4연건연합ANCA진단궤양성결장염、ASCA진단극라은병적총민감도、특이도、양성의연비、음성의연비、진단비치비、수시자공작곡선하면적분별위0.51、0.92、6.06、0.53、12.56、0.79、0.56、0.92、5.13、0.57、10.33、0.82。결론 ANCA、ASCA유리우IBD아조적진단，림상표현의사적수진환자가선행해검사，혈청표지물양성자급여조기치료，음성후재완선결장경검。해사로대증가의종성、질병예후균구유중요의의。
Objective To assess diagnosis value of detecting ANCA and ASCA on adult IBO subgroups. Methods Through searching literatures involving in correlations between ANCA,ASCA and adult colitis gravis and Crohn′s disease(CD) in and aboard,adopting the QUADAS—2 scale to assess the quality of the literatures included and metadisc heterogeneous computing , The combined sensitivity,specificity,positive likelihood ratio,negative likelihood ratio as well as the diagnostic odds ratio,the curve of the testees was drawn. Results In line with the inclusion and exclusion standards ,13 independent studies were considered. The pooled sensitivity,specificity,positive and negative likehood ratio,diagnostic odds ratio and area under curve (AUC) in diagnosis of colitis gravis by ANCA with meta—disc1.4 software were 0.51,0.92,6.06,0.53,12.56,0.79,0.56,0.92,5.13, 0.57,10.33,0.8169 accordingly and those of and CD by ASCA being 0.56,0.92,5.13,0.57,10.33,0.82 successively. Conclusion ANCA and ASCA are beneficial to the diagnosis of IBD subgroups. The suspected patients in clinic may select this examina—tions. Those whose serum markers are positive may treated as early as possible ,the others who are negative may choose the colonoscopy examination. The thought is subject to major significance i improving the compliance and prognosis. More prospec—tive,double—blind,large—size samples were required to verify its clinical value further.
