血清免疫抗原在包虫病诊断中的价值Meta分析  

Value of serum immune antigens in the diagnosis of hydatid disease:a Meta-analysis

作　　者：阿依别克·吐尔得汉 陈伦牮[2] 巴合体·卡力甫 陈雄[2] 梦塬 Ayibieke·Tuerdehan;Chen Lunjian;Baheti·Kalifu;Chen Xiong;Meng Yuan(Graduate School,Xinjiang Medical University,Urumqi 830054,China;Department of Hepatobiliary Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区医科大学研究生院,乌鲁木齐830054 [2]新疆维吾尔自治区人民医院肝胆外科,乌鲁木齐830001

出　　处：《中华肝脏外科手术学电子杂志》2023年第3期300-304,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：新疆维吾尔自治区自然科学基金(2018D01C131)。

摘　　要：目的:探讨ELISA检测血清免疫抗原在包虫病诊断中的价值。方法:计算机检索PubMed、Cochrane Library、中国知网和万方数据库中关于ELISA检测包虫病血清免疫抗原的相关文献。检索时间范围为从建库至2021年2月1日。英文检索词:serological diagnosis,hydatid disease,antigen。中文检索词:血清学诊断,包虫病,棘球蚴病,抗原。由2名文献评价人员根据纳入与排除标准对文献进行筛选,并提取所需的数据。根据诊断准确性研究质量评估(QUADAS)标准对纳入文献质量进行评价。采用集成ROC曲线(SROC)评价诊断试验的阈值效应。结果:最终纳入20篇文献,共2032例经金标准确诊的包虫病患者,1521例相似病例及1824例健康人。总体血清免疫抗原诊断实验结果显示,SROC曲线下面积为0.94,考虑其无阈值效应,采用随机效应模型进行Meta分析,结果显示合并敏感度为0.84,合并特异度为0.81,合并阳性似然比为7.41,合并阴性似然比为0.16,合并诊断比值比为50.45。HCF抗原诊断试验的合并敏感度为0.92,合并特异度为0.84,合并阳性似然比为7.87,合并阴性似然比为0.10;AgB抗原诊断试验相应为0.82、0.80、10.09、0.16;Eg抗原诊断试验相应为0.86、0.79、4.14、0.15;Em抗原诊断试验相应为0.74、0.93、8.86、0.20;H3抗原诊断试验相应为0.84、0.81、2.72、0.12。结论:采用ELISA法检测血清免疫抗原在包虫病的诊断中具有较高的敏感度和特异度,其中HCF和AgB抗原诊断价值较高。Objective To evaluate the diagnostic value of ELISA detection of serum immune antigens for hydatid disease.Methods Literature search related to ELISA detection of serum immune antigens in hydatid disease was conducted in PubMed,Cochrane Library,CNKI and Wanfang Data from the inception date of databases to February 1,2021.The searching terms included serological diagnosis,hydatid disease,hydatidosis and antigen in both Chinese and English.The literature screening was performed by two reviewers according to the inclusion and exclusion criteria,and required data were extracted.The Quality Assessment of Diagnostic Accuracy Studies(QUADAS)was used to assess each study's methodological quality.The summary receiver operating characteristic(SROC)curve was adopted to evaluate the threshold effect of diagnostic test.Results 20 articles were eventually included,including2032 cases of hydatid disease diagnosed by gold standard criteria,1521 resembling cases and 1824 healthy individuals.The diagnostic results of total serum immune antigen showed that the area under SROC curve was 0.94.Considering the non-threshold effect,Meta-analysis was conducted by using random effect model.The pooled sensitivity was 0.84,the pooled specificity was 0.81,the pooled positive likelihood ratio was 7.41,the pooled negative likelihood ratio was 0.16,and the pooled diagnostic odds ratio was 50.45,respectively.The pooled sensitivity,specificity,positive likelihood ratio and negative likelihood ratio of HCF antigen diagnostic test were 0.92,0.84,7.87 and 0.10,and 0.82,0.80,10.09 and 0.16 for AgB antigen,and 0.86,0.79,4.14 and 0.15 for Eg antigen,and 0.74,0.93,8.86 and 0.20 for Em antigen,and 0.84,0.81,2.72 and 0.12 for H3 antigen,respectively.Conclusions ELISA detection of serum immune antigens yields high sensitivity and specificity in the diagnosis of hydatid disease,among which HCF and AgB antigens possess higher diagnostic value.

关 键 词：棘球蚴病 HCF抗原 AgB抗原 诊断 META分析 酶联免疫吸附试验 

分 类 号：R532.32[医药卫生—内科学]