基因芯片方法检测耐异烟肼结核分枝杆菌准确性的Meta分析  

Meta analysis on accuracy of gene chip method in identifying isoniazide-resistant mycobacterium tuberculosis

作　　者：舒丽红[1,2] 丁显平[1] 

机构地区：[1]四川大学生命科学学院,成都610041 [2]成都市第七人民医院检验科,610041

出　　处：《检验医学与临床》2016年第15期2121-2125,共5页Laboratory Medicine and Clinic

摘　　要：目的 利用Meta分析方法系统评价基因芯片技术检测耐异烟肼（INH）结核分枝杆菌的准确性。方法 计算机检索The Cochrane Library、SCI、PubMed、EMbase、WanFang Data、CNKI数据库,检索时限均为建库至2015年5月。由2位研究者根据纳入与排除标准筛选文献、提取资料,应用QUADAS条目工具评价纳入研究质量,采用Meta-DiSc 1.4软件对敏感性（SEN）、特异性（SPE）、阳性似然比（＋LR）、阴性似然比（-LR）、诊断比值比（DOR）进行异质性检验和合并分析并绘制受试者工作特征（SROC）曲线、计算曲线下面积（AUC）。结果 共纳入15篇符合要求文献,分析3 967株经传统药敏试验鉴定结核分枝杆菌菌株,其中耐INH菌株1 147株、敏感菌株2 820株。基因芯片技术检测耐INH结核分枝杆菌的SEN_（并发）为0.82[95%CI（0.79~0.84）]、SPE_（并发）为0.97[95%CI（0.97~0.98）]、＋LR为21.81[95%CI（12.12~39.25）]、-LR为0.19[95%CI（0.15~0.24）]、DOR_（并发）为136.55[95%CI（70.66~263.89）],AUC为0.94。结论 通过循证学方法系统评价基因芯片技术检测耐INH结核分枝杆菌结果表明,其具有较好的诊断价值;与传统药敏试验相比基因芯片技术操作简单、检测快速,对耐药基因检出率较高,但费用较贵,成本较高。Objective To systematically evaluate the accuracy of gene chip technology in identifying isoniazide（INH）‐resistant mycobacterium（M .） tuberculosis by using the meta analysis method .Methods The diagnostic tests of gene chip versus drug sensi‐tive test（gold standard） were retrieved from Cochrane Library ,SCI ,PubMed ,EMbase ,WanFang Data and CNKI by computer .The retrieval time was from the database establishment to May 2015 .Two reviewers independently screened the literatures according to the inclusion and exclusion criteria ,extracted the data ,and assessed the methodological quality of the included studies according to the QUADAS items .The Meta‐DiSc software （version 1 .4） was used to conduct the pooling analysis on sensitivity（SEN） ,specific‐ity（SPE） ,positive likelihood ratio（＋ LR） ,negative likelihood ratio（-LR） diagnostic odds ratio（DOR） .The heterogeneity test was performed and the summary receiver operating characteristic （SROC） curve was drawn for calculating the area under the curve （AUC） .Results A total of 15 domestic studies and foreign studies were totally included ,involving 3 967 strains of M .tuberculosis identified by the conventional drug susceptibility test（DST） ,including 1 147 INH‐resistant strains and 2 820 sensitive strains .The SENmerging of INH‐resistant M .tuberculosis detected by gene chip technology was 0 .82[95% CI （0 .79 -0 .84）] ,SPEmerging 0 .97 [95% CI （0 .97-0 .98）] ,＋ LR was 21 .81[95% CI （12 .12-39 .25）] ,-LR was 0 .19[95% CI （0 .15-0 .24）] ,DORmerging 136 .55 [95% CI（70 .66-263 .89）] ,AUC was 0 .94 .Conclusion The evidence‐based method systematic evaluation indicates that the gene chip technology has a good diagnostic value in identifying INH‐resistant M .tuberculosis .Compared with the traditional DST ,the gene chip technology is simple operating ,rapidly detect ,which has higher detection rate of drug resistant gene ,but its cost is high‐er .

关 键 词：基因芯片技术 耐药结核分枝杆菌 KATG基因 系统评价 药敏试验 

分 类 号：R52[医药卫生—内科学]