外周血结核感染T细胞斑点试验对脊柱结核诊断价值的Meta分析  

Meta-analysis of T-SPOT. TB test for diagnosing spinal tuberculosis

作　　者：姚利 盛健 王冰 戴希勇 YAO Li;SHENG Jian;WANG Bing;DAI Xiyong(Department of Surgery,Wuhan Pulmonary Hospital,Wuhan 430030,China)

机构地区：[1]武汉市肺科医院外科,430030

出　　处：《中国防痨杂志》2019年第10期1084-1089,共6页Chinese Journal of Antituberculosis

摘　　要：目的系统评价外周血结核感染T细胞斑点试验(T-cell spot of tuberculosis,T-SPOT.TB)在脊柱结核诊断中的应用价值。方法通过计算机检索中国知网、万方、维普、PubMed、EMBASE、Cochrane Library等数据库,获得以T-SPOT.TB诊断脊柱结核的相关文献,检索起止时间为建库至2019年6月。由2名研究者独立进行文献检索、筛选、数据提取,质量评价,以MetaDisc 1.4软件进行Meta分析。结果共检索出219篇文献,依据纳入和排除标准最终纳入8篇文献。外周血T-SPOT.TB诊断脊柱结核的汇总敏感度为88.0%(95%CI:85.0%~91.0%),汇总特异度为90.0%(95%CI:86.0%~93.0%),汇总阳性似然比为8.67(95%CI:6.47~11.62),汇总阴性似然比为0.13(95%CI:0.10~0.16),汇总诊断OR值为63.14(95%CI:42.14~94.60),汇总受试者工作特征曲线下面积为0.95。结论外周血T-SPOT.TB对脊柱结核具有较高的诊断价值,可作为快速诊断脊柱结核的有效方法。Objective To systematically review the diagnostic value of the T-SPOT.TB test of peripheral blood for diagnosing spinal tuberculosis.Methods All literatures involved the diagnostic value of the T-SPOT.TB test of peripheral blood for diagnosing spinal tuberculosis which published from establishment to June 2019 were identified from CNKI,WanFang Data,VIP,PubMed,EMBASE,Cochrane Library,etc.Two researchers independently conducted literature search,screened the literature according to the inclusion and exclusion criteria,extracted data,and assessed the quality of included studies.MetaDisc 1.4 were used to conduct the meta-analysis.Results A total of 219 articles were retrieved and 8 articles were eventually included based on inclusion and exclusion criteria.The cumulative sensitivity of peripheral blood T-SPOT.TB test for the diagnosis of spinal tuberculosis was 8 8.0%(95%CI:85.0% to 91.0%),and the specificity (SPE) was 90.0%(95%CI:86.0%-93.0%),the positive likelihood ratio (PLR) was 8.67 (95%CI:6.47-11.62),the negative likelihood ratio (NLR) was 0.13 (95%CI:0.10-0.16),the diagnosis odds ratio (OR) was 63.14 (95%CI:42.14-94.60),and the area under the curve (AUC) of summary receiver operating characteristics (SROC) was 0.95.Conclusion T-SPOT.TB test of peripheral blood plays a valuable role in the diagnosis of spinal tuberculosis and can be used as an effective method for rapid diagnosis of spinal tuberculosis.

关 键 词：结核 脊柱 酶联免疫斑点检测 诊断 META分析 Γ干扰素释放试验 

分 类 号：R529.2[医药卫生—内科学]