抗α-胞衬蛋白抗体对干燥综合征的诊断价值:一项meta分析  

A meta analysis on the diagnosis significance of anti-alpha-fodrin antibodies for Sjgren′s syndrome

作　　者：秦琴[1] 孙懿[1] 谷明莉[1] 胡志德[2] 陈孙孝[3] 邓安梅[1] 

机构地区：[1]第二军医大学附属长海医院实验诊断科,上海200433 [2]济南军区总医院实验诊断科,山东济南250031 [3]第二军医大学附属长征医院皮肤科,上海200003

出　　处：《检验医学》2012年第12期1074-1079,共6页Laboratory Medicine

基　　金：国家自然科学基金资助项目(30972730);上海市科委基金资助项目(09JC1405400;11JC1410902)

摘　　要：目的探讨抗α-胞衬蛋白抗体对干燥综合征(SS)的诊断价值。方法对已经发表的采用酶联免疫吸附试验(ELISA)检测抗α-胞衬蛋白抗体诊断SS(以2002年国际标准为诊断依据)的文献进行了分析,并且采用随机效应模型分析了ELISA检测抗α-胞衬蛋白抗体对SS的总体诊断敏感性、特异性、阳性似然比(PLR)、阴性似然比(NLR)和诊断优势比(DOR)。以汇总受试者工作特征(sROC)曲线分析抗α-胞衬蛋白抗体的总体诊断性能。结果最终有7项研究进入了本次meta分析,ELISA检测抗α-胞衬蛋白抗体IgA、IgG的总体诊断敏感性[95%可信区间(CI)]分别为0.30(0.25～0.34)和0.32(0.28～0.36),总体特异性分别为0.90(0.87～0.93)和0.83(0.80～0.86)。已有的研究质量并不高,且之间存在较大的异质性。结论抗α-胞衬蛋白抗体对SS具有较高的诊断特异性,但其诊断敏感性并不理想。对抗α-胞衬蛋白抗体的结果解释应建立在患者临床特征之上。Objective To investigate the diagnosis significance of anti-alpha-fodrin antibodies for Sjgren＇s syndrome （SS）. Methods After a systematic review of literatures, the sensitivity, specificity, positive and negative likelihood ratios （PLR/NLR） and diagnosis advantage ratio （DOR） of anti-alpha-fodrin antibodies by enzyme-linked immunosorbent assay （ELISA） in the diagnosis of SS defined by international 2002 criteria were pooled by random-effect models. Summary receiver operating characteristic （sROC） curves were used to summarize the overall determination performance. Results Seven studies met the criteria. The summary evaluations for anti-alpha-fodrin antibody IgA and IgG in the diagnosis of SS were as follows： sensitivities 0.30 [95% confidence interval （CI） 0. 25-0.34] and 0.32 （95 % C10. 28-0.36 ） ; specificities 0.90 （95 % CI 0. 87-0.93 ） and 0.83 （95 % CI 0. 80-0.86 ）, respectively. The designed studies were with low quality, and the significant heterogeneity was observed. Conclusions Anti-alpha-fodrin antibodies have poor sensitivity and high specificity for the diagnosis of SS. The explanation for anti-alpha-fodrin antibody determination resuh should be based on clinical features.

关 键 词：抗Α-胞衬蛋白抗体 干燥综合征 META分析 

分 类 号：R446.62[医药卫生—诊断学]