唾液胃蛋白酶检测对胃食管反流病诊断价值的Meta分析  

Diagnostic value of pepsin in saliva for gastroesophageal reflux disease:a Meta-analysis

作　　者：吴昊[1] 陈婧[2] 郭宝娜[2] 李莉[2] 姜佳丽[2] 王凝[2] 张川[2] 展玉涛[2] 郭子皓[2] WU Hao;CHEN Jing;GUO Baona;LI Li;JIANG Jiali;WANG Ning;ZHANG Chuan;ZHAN Yutao;GUO Zihao(Department of Cardiovascular Diseases,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Department of Gastroenterology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院心内科,北京100730 [2]首都医科大学附属北京同仁医院消化内科,北京100730

出　　处：《胃肠病学和肝病学杂志》2020年第12期1369-1374,共6页Chinese Journal of Gastroenterology and Hepatology

基　　金：北京市医管局消化协同中心特色项目(XXT09)。

摘　　要：目的系统评价唾液中胃蛋白酶检测对胃食管反流病(gastroesophageal reflux disease,GERD)的诊断价值。方法通过计算机检索万方、CNKI、PubMed、Embase及Cochran数据库,制定检索方式对发表过的关于唾液中胃蛋白酶检测对GERD诊断价值的研究进行检索。收集1980年1月至2020年1月相关的全部文献,由2位评价者共同进行筛选文献、数据提取、质量评价并评价偏倚风险后,应用Stata 13及Meta-disc 1.4统计软件进行Meta分析。结果最终纳入13项研究,共1221例患者及883例对照者。唾液胃蛋白酶诊断GERD的各研究的灵敏度合并为79.3%(95%CI:76.9%~81.6%),特异度合并为66.1%(95%CI:62.9%~69.2%),阳性似然比(PLR)为2.2(95%CI:1.6~2.9),阴性似然比(NLR)为0.44(95%CI:0.31~0.63),诊断比值比(DOR)为5.4(95%CI:3.0~9.8),汇总受试者工作特征(SROC)曲线的曲线下面积(AUC)为0.76,提示具有较好的诊断价值。结论唾液中胃蛋白酶检测对GERD具有较好的诊断价值,可辅助GERD的诊断。Objective To summarize the utility of salivary pepsin detection for diagnosis of gastroesophageal reflux disease(GERD).Methods WanFang Data,CNKI,PubMed,Embase and the Cochran Library(from Jan.1980 to Jan.2020)were searched for pepsin in saliva for GERD diagnosis.Two reviewers screened literature,extracted the data,and assessed the methodological quality together.Meta-analysis was performed with Stata 13 and Meta-disc 1.4 software.Results A total of 13 articles which includes 1221 patients and 883 controls were analyzed.The pooled sensitivity and specificity for the diagnosis of salivary pepsin detection for GERD were 79.3%(95%CI:76.9%~81.6%)and 66.1%(95%CI:62.9%~69.2%),respectively.The pooled positive likelihood ratio(PLR)and negative likelihood ratio(NLR)were 2.2(95%CI:1.6~2.9)and 0.44(95%CI:0.31~0.63),respectively.The summarized diagnostic odds ratios(DOR)and AUC were 5.4(95%CI:3.0~9.8)and 0.76,respectively.Conclusion Salivary pepsin dectection is with diagnostic odds ratios moderate diagnostic value for GERD diagnosis.

关 键 词：胃食管反流病 唾液 胃蛋白酶 诊断 META分析 

分 类 号：R57[医药卫生—消化系统]