不同流行程度下日本血吸虫病血清学诊断方法方法的Meta分析  

Serological diagnosis methods of schistosomiasis japonica at different prevalence:a meta-analysis

作　　者：王鑫瑶 杨坤[1] 

机构地区：[1]江苏省血吸虫病防治研究所、卫生部寄生虫病预防与控制技术重点实验室、江苏省寄生虫分子生物学重点实验室,无锡214064

出　　处：《中国血吸虫病防治杂志》2016年第1期18-25,29,共9页Chinese Journal of Schistosomiasis Control

基　　金：国家重大传染病科技专项(2012ZX10004-220);国家自然科学基金(81101275);江苏省卫生厅重点人才项目(RC2011094);江苏省公益院所能力提升项目(BM2015024)

摘　　要：目的通过Meta分析,综合评价不同流行程度下间接血凝实验(IHA)、酶联免疫吸附测定(ELISA)和胶体染料试纸条法(DDIA)的日本血吸虫病诊断效果。方法通过文献检索,按照纳入和排除标准建立数据库,采用Meta-disc和R软件进行阈值检验、异质性检验、效应量加权定量合并及SROC曲线拟合等Meta分析。结果共有60篇文献符合纳入标准。IHA在重、中度及低度流行区的灵敏度分别为0.84、0.76和0.94,特异度分别为0.73、0.64和0.73;ELISA在重、中度及低度流行区的灵敏度分别为0.88、0.80和0.93,特异度分别为0.59、0.59和0.62;DDIA在重、中度及低度流行区的灵敏度分别为0.93、0.81和0.93,特异度分别0.66、0.69和0.59。IHA、ELISA与DDIA的加权合并灵敏度分别为0.83、0.87和0.90;加权合并特异度为0.69、0.60和0.62。IHA、ELISA和DDIA的总体SROC曲线下面积分别为0.89、0.96和0.92。结论不同流行程度下,血吸虫病血清学诊断方法的检验效能存在一定差异。血吸虫病诊断试剂的灵敏度与特异度均需进一步提高。Objective To comprehensively evaluate the effects of indirect hemagglutination test （IHA）, enzyme-linked immunosorbent assay （ELISA）, and dipstick dye method （DDIA） in the diagnosis of schistosomiasis japonica at different prevalence by using Meta-analysis. Methods Through the literature review according to the inclusion and exclusion criteria, a database was established, and by using Meta-disc and R software, the Meta-analysis was performed including the threshold test, heterogeneity test, weighted by the quantitative effect of merger, SROC curve fitting, etc. Results A total of 60 papers were included in the final analysis. The sensitivities of IHA were 0.84, 0.76 and 0.94 in heavy, medium and low endemic areas, and specificities were 0.73, 0.64 and 0.73 respectively ; the sensitivities of ELISA were 0.88, 0.80 and 0.93 in heavy, medium and low endemic areas, and the specificities were 0.59, 0.59 and 0.62 respectively; the sensitivities of DDIA were 0.93, 0.81 and 0.93 in the heavy, medium and low endemic areas, and specificities were 0.66, 0.69 and 0.59 respectively. The weighted sensitivities of IHA, ELISA and DDIA were 0.83, 0.87 and 0.90 respectively ; the weighted specificities were 0.69, 0.60 and 0.62 respectively. The areas under the curve of SROC were 0.89, 0.96 and 0.92 in IHA, ELISA and DDIA respectively. Conclusions In different prevalence, the effectiveness of different methods for serological diagnosis of schistosomiasis is different. The sensitivity and specificity of all diagnostic methods of schistosomiasis need to further improve.

关 键 词：日本血吸虫病 间接血凝实验(IHA) 酶联免疫吸附测定(ELISA) 胶体染料试纸条法(DDIA) 灵敏度 特异度 检验效能 META分析 

分 类 号：R532.21[医药卫生—内科学]