T细胞酶联免疫斑点法诊断结核性脑膜炎的Meta分析  

Meta analysis of T-SPOT.TB test for diagnosing tuberculous meningitis

作　　者：马秀英[1] 姚云清[1] 佘轩[1] 龙琴[1] 颜成果 张清秀[1] 

机构地区：[1]重庆医科大学附属第一医院感染科/教育部国家重点学科,400016

出　　处：《重庆医学》2014年第25期3299-3301,3304,共4页Chongqing medicine

摘　　要：目的：探讨脑脊液和外周血T细胞酶联免疫斑点法（T-SPOT．TB）检测在结核性脑膜炎中的诊断价值。方法检索1990年1月至2013年10月PubMed、EMBASE等数据库，收集以T-SPOT．TB法诊断结核性脑膜炎的文献。由两位研究者独立筛选文献，提取资料，质量评价，以 Meta-Disc 1．4软件进行 Meta分析。结果共纳入8篇文献，425个病例，结核性脑膜炎232例。外周血组合并灵敏度为80％（95％CI：0．74～0．85），合并特异度为74％（95％CI：0．67～0．80），SROC 曲线下面积为0．8587；诊断比值比为15．50。脑脊液组合并灵敏度为76％（95％CI：0．70～0．82），合并特异度为83％（95％CI：0．77～0．88）， SROC曲线下面积为0．8927；合并诊断比值比为22．62。结论采用 T-SPOT．TB法有助于提高结核性脑膜炎的诊断率。脑脊液T-SPOT．TB诊断准确性可能高于外周血组。Objective To investigate the diagnostic value of the T-SPOT.TB test for diagnosing tuberculous meningitis（TBM） by meta-analysis.Methods A systematic retrieval from the databases of PubMed,EMBASE,etc.was performed.The literature on the T-SPOT.TB test for diagnosing TBM was collected.Two reviewers independently screened the literature,extracted the data and judged the quality.The meta analysis was conducted by the Meta-Disc 1.4 software.Results 8 articles were included,involving 425 patients including 232 cases of TBM.In the peripheral blood group,the combined sensitivity was 80%（95%CI：0.74-0.85）,the combined specificity was 74%（95%CI：0.67-0.80）,the area under the curve（AUC）of summary receiver operating characteristic （SROC）was 0.858 7;the diagnostic odds ratio（DOR）was 15.50.In the CSF group,the combined sensitivity was 76%（95%CI：0.70-0.82）,the combined specificity was 83%（95%CI：0.77-0.88）,AUC was 0.892 7;DOR was 22.62.Conclusion Adopting the T-SPOT.TB test conduces to increase the diagnostic rate of TBM.The diagnostic accuracy of the T-SPOT.TB test for CSF may be higher than that for peripheral blood.

关 键 词：T淋巴细胞 酶联免疫吸附测定 结核 脑膜 META分析 

分 类 号：R529.3[医药卫生—内科学]