中国开展基因芯片检测结核分枝杆菌对异烟肼和利福平耐药性的Meta分析  

Evaluation of genechip for detecting isoniazid- and rifampicin-resistance of Mycobacterium tuberculosis in China： a Meta-analysis

作　　者：耿红[1] 李永文[1] 李新旭[2] 王志萍[3] 陶武威 于春宝[1] 

机构地区：[1]山东省胸科医院结核病防治中心,济南250101 [2]中国疾病预防控制中心结核病预防控制中心 [3]山东大学公共卫生学院

出　　处：《中华传染病杂志》2014年第6期357-363,共7页Chinese Journal of Infectious Diseases

摘　　要：目的 评价中国开展基因芯片检测结核分枝杆菌（MTB）对异烟肼和利福平耐药性的诊断效果.方法 通过检索PubMed数据库、Science Direct数据库、中国生物医学文献光盘数据库、中国期刊全文数据库和万方数据库,收集1995年1月至2013年6月发表的在中国开展基因芯片检测MTB对异烟肼和利福平耐药性的相关文献,使用Meta-Disc1.4软件进行分析.结果 共检索到中、英文文献618篇,其中15篇纳入本研究,发表时间为2004年至2013年.Meta分析结果显示,基因芯片检测MTB对异烟肼耐药性的总灵敏度为0.79（95％CI为0.77～0.81）,特异度为0.94（95％CI为0.93～0.95）,曲线下面积（AUC）为0.86;检测利福平的总灵敏度为0.91（95％CI为0.89～0.92）,特异度为0.96（95％CI为0.96～0.97）,AUC为0.97;诊断耐多药MTB的总灵敏度为0.75（95％CI为0.72～0.78）,特异度为0.97（95％CI为0.96～0.98）.结论 中国开展基因芯片检测MTB对异烟肼耐药性的检测效能中等,对利福平耐药性的检测效果较好;基因芯片检测耐多药MTB的诊断价值尚需进一步研究.Objective To evaluate the effect of genechip in detecting isoniazid-and rifampicinresistance of Mycobacterium tuberculosis （MTB） in China.Methods Studies of genechip in detecting MTB resistance to isoniazid and rifampicin in China,which were published from January 1995 to June 2013,were identified through searches of PubMed,Science Direct,CBMDISC,CNKI and Wanfang database.Meta-Disc1.4 software was used for all analyses.Results Totally 618 articles were identified.Fifteen articles published from 2004 to 2013 were finally included in the study.The pooled sensitivity and specificity of genechip in detecting MTB resistance to isoniazid was 0.79 （95 ％CI：0.77-0.81） and 0.94 （95％CI：0.93-0.95）,respectively,with the area under curve （AUC） of 0.86.The pooled sensitivity and specificity of genechip in detecting MTB resistance to rifampin was 0.91 （95％CI：0.89-0.92） and 0.96 （95％CI：0.96-0.97）,respectively,with the AUC of 0.97.The pooled sensitivity and specificity of genechip in detecting MTB resistance to multidrug was 0.75 （95％CI：0.72-0.78） and 0.97 （95％ CI：0.96-0.98）,respectively.Conclusions The effect of genechip in detecting MTB resistance is moderate for isoniazid,while better for rifampin in China.More studies are needed to evaluate the effect of genechip in detecting multidrug resistance in MTB.

关 键 词：分枝杆菌 结核 结核病 寡核苷酸序列分析 META分析 

分 类 号：R52[医药卫生—内科学]