ELISPOT(酶联免疫斑点技术)对肺结核诊断价值的Meta分析  

Meta Analysis of Tuberculosis Diagnostic Value of ELISPOT(Enzyme-Linked Immunospot)

作　　者：孙超 李磊 王颖 高娟娟 Sun Chao;Li Lei;Wang Ying;Gao Juanjuan(Yantai International Travel Healthcare Center（Yantai,Shandong,37060)

机构地区：[1]烟台国际旅行卫生保健中心,山东烟台264000

出　　处：《口岸卫生控制》2018年第5期31-38,共8页Port Health Control

基　　金：SK201718酶联免疫斑点技术(ELISPOT)在口岸开放性肺结核筛查和快速诊断中的应用研究

摘　　要：目的评价ELISPOT方法对肺结核的诊断价值。方法收集公开发表的有关ELISPOT对肺结核诊断价值的研究文献,根据制定的文献纳入与排除标准对文献进行筛选,利用QUADAS量表对入选文献进行质量评价,对符合条件的研究进行Meta分析。结果共入选17篇文献,其中中文14篇,英文3篇,16篇文献质量为优,1篇为差,共纳入研究对象2813人,Spearman相关分析结果显示不存在阈值效应,但DOR的Cochran-Q检验显示存在非阈值效应引起的异质性,异质性值I2为61.8%,提示存在中等异质性,采用随机效应模型进行合并分析,得到汇总灵敏度、特异度、阳性似然比、阴性似然比分别为0.88(0.86～0.90)、0.85(0.83～0.87)、6.05(4.74～7.71)、0.14(0.11～0.18),SROC曲线AUC为0.94,Q^2为0.88。结论 ELISPOT方法对肺结核具有较高的诊断价值,但是仍需进一步的扩大样本量,进行多中心的系统研究,进行相应的亚组分析与分层分析,找出异质性的来源。Objective To evaluate the diagnostic value of ELISPOT method for tuberculosis. Methods Those published literature on the diagnostic value of ELISPOT for tuberculosis were collected,the literature was screened according to the established inclusion and exclusion criteria, the quality of the included literature was evaluated using the Q UADAS scale, and the eligible situation were meta-analyzed. Results A total of 17 literatures were selected,including 14 Chinese literatures,3 English literatures,which showed 16 literatures of excellent quality and one of poor quality,whereas a total of 2,813 subjects were included in the study. Spearman correlation analysis of the above literature showed no threshold effect,but DOll＇s Cochran-Q test showednon- threshold effect caused heterogeneity,I2 heterogeneity values was 61.8% ,suggesting moderate heterogeneity. The combined analysis was conducted using the random effect model, and the aggregation sensitivity, specificity, posi- tive likelihood ratio,and negative likelihood ratio were 0.88 （0.86~0.90）,0.85 （0.83-0.87）,6.05 （4.74 - 7.71）, and 0.14（0.1l - 0.18）,respectively. The SllOC curve AUC was 0.94 whereas Q2 was 0.88. Conclusion ELISPOT methodshows that of high diagnostic value for tuberculosis,but it＇s still needed to further expand the sample size ,to carry out multi-center systematic research,carry out corresponding subgroup analysis and stratification analysis, and then to find out the source of heterogeneity.

关 键 词：酶联免疫斑点技术 肺结核 META分析 

分 类 号：R521[医药卫生—内科学]