免疫比浊法和高效液相色谱法测定糖化血红蛋白一致性的Meta分析  

Meta analysis of consistency for glycated hemoglobin tested by immunoturbidimetric assay and high performance liquid chromatography

作　　者：孙利谦 金春林[2] 张志杰[1] 王海银[2] 

机构地区：[1]复旦大学公共卫生学院流行病与卫生统计学教研室,上海200032 [2]上海市医学科学技术情报研究所上海市卫生发展研究中心

出　　处：《中国糖尿病杂志》2016年第10期885-891,共7页Chinese Journal of Diabetes

基　　金：美国中华医学基金会卫生体系研究与政策转化合作项目(CMB-CP 14-190)

摘　　要：目的系统评价免疫比浊法和高效液相色谱法(HPLC)测定HbA_1c的一致性。方法计算机检索国内外重要数据库,搜索有关免疫比浊法和HPLC测定HbA1c的方法学评价文献。按照纳入和排除标准筛选文献,提取资料及进行方法学质量评价(QUADAS量表),并采用Stata 12.0软件进行Meta分析。结果共纳入8篇文献,合计3634例患者。免疫比浊法测定HbA_1c与HPLC测定结果检验,差异无统计学意义(Z=0.77,P=0.444);漏斗图、Begg秩相关检验(Z=1.36,P=0.174)及Egger线性回归法(t=1.91,P=0.105)均提示无发表偏倚;敏感性分析结果说明敏感性低,结果可信;亚组分析表明,小样本组较大样本组仍存在较高的异质性,中国的研究异质性较外国高。结论免疫比浊法和HPLC测定HbA_1c一致性较好,检测结果有可比性。Objective To assess the consistency of glycated hemoglobin（HbA_1c）tested by immunoturbidimetric assay and high performance liquid chromatography（HPLC）. Methods Major databases were searched to get methodological evaluation of immunoturbidimetric assay and HPLC in detecting HbA_1c for diabetes.The retrieved studies were screened according to the inclusion criteria and exclusion criteria.Data were extracted,the quality of the included studies was evaluated and meta-analysis was performed using Stata 12.0software. Results A total of 8studies involving 3634 cases were included in this analysis.There was no significant difference in the value of HbA_1c detected by immunoturbidimetric assay and HPLC（Z=0.77,P=0.444）.Funnel plot,Begg rank correlation test（Z=1.36,P=0.174）and Egger regression test（t=1.91,P=0.105）indicated no publication bias.Sensitivity analysis showed that the result was relatively robust.Subgroup analysis showed that small sample group had higher heterogeneity than larger sample group.Compared with foreign studies,the studies from China had higher heterogeneity. Conclusion This meta analysis shows that immunoturbidimetric assay and HPLC have good consistency in the testing of HbA_1c.

关 键 词：糖化血红蛋白 免疫比浊法 高效液相色谱法 系统评价 META分析 

分 类 号：R587.1[医药卫生—内分泌]