PCR诊断儿童肺炎支原体肺炎的Meta分析  

A Meta-analysis of Applying PCR for the Diagnosis of Mycoplasma Pneumoniae Pneumonia in Children

作　　者：吴喜蓉 张学伶[1,2] 尹青琴 刘小会 闫玫汝[1,2] 刘雅莉 徐保平[1,2] WU Xirong;ZHANG Xueling;YIN Qingqin;LIU Xiaohui;YAN Meiru;LIU Yali;XU Baoping(National Center for Children’s Health,National Clinical Research Center of Respiratory Diseases,Beijing 100045,China;Respiratory Department,Beijing Children’s Hospital,Capital Medical University,Respiratory Department,Research Unit of Critical infection in Children,Chinese Academy of Medical Sciences,Beijing 100045,China;Department of Pharmacy,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China;Center of Clinical Epidemiology and Evidence-Based Medicine,Beijing Children's Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,国家呼吸系统疾病临床医学研究中心,北京100045 [2]首都医科大学附属北京儿童医院呼吸科,中国医学科学院儿童危重感染诊治创新单元,北京100045 [3]首都医科大学附属北京儿童医院药学部,北京100045 [4]首都医科大学附属北京儿童医院临床流行病与循证医学中心,北京100045

出　　处：《标记免疫分析与临床》2024年第9期1569-1574,共6页Labeled Immunoassays and Clinical Medicine

基　　金：中国医学科学院临床与转化医学研究专项(编号:2023-I2M-C&T-A-015);北京市高层次公共卫生技术人才培养计划项目(编号:2022-2-023);北京市研究型病房建设示范单位项目(编号:BCRW202101)。

摘　　要：目的以双份血清抗体恢复期4倍及以上升高或肺炎支原体(Mycoplasma pneumoniae,MP)培养为金标准,通过Meta分析评价聚合酶链式反应(polymerase chain reaction,PCR)法对儿童肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)的诊断价值。方法检索PubMed、生物医学与药理学文摘型数据库(Excerpta Medica Database,Embase)、考克兰图书馆(Cochrane Library)、中国生物医学文献服务系统(Chinese Biomedical Literature Database,Sinomed)、中国知网(China National Knowledge Infrastructure,CNKI)、万方和维普数据库关于PCR诊断儿童MPP的相关文献。检索起止时间为建库至2023年3月31日。2名研究者根据纳排标准筛选文献,采用偏倚评估工具(quality assessment of diagnostic accuracy studies,QUADAS)-2量表评价文献质量,采用Meta-Disc 1.4软件进行Meta分析。结果纳入7篇文献,1620例临床样本。Meta分析结果显示,PCR法诊断儿童MPP的汇总灵敏度、特异性、阳性似然比和阴性似然比分别为87%(95%CI 85%~89%)、89%(95%CI 86%~92%)、5.21(95%CI 2.85~9.52)、0.19(95%CI 0.10~0.37),绘制汇总受试者工作特征(summary receiver operating characteristic curve,SROC),计算曲线下面积(area under curve,AUC)为0.915,Q*指数为0.8476。结论PCR诊断儿童MPP的灵敏度和特异性均较高,可用于临床诊断儿童MPP。Objective To evaluate the accuracy of Polymerase Chain Reaction(PCR)application in the diagnosis of Mycoplasma pneumoniae pneumonia(MPP)in children by meta-analysis using double serum antibody recovery period 4 times or higher or Mycoplasma pneumoniae(MP)culture as the gold standard.Methods PubMed,Embase,Cochrane Library,Chinese Biomedical Literature Service system(Sinomed),China National Knowledge Infrastructure(CNKI),Wanfang and VIP databases were searched for studies of PCR diagnosis for MPP.The retrieval period was from the database construction to March 31,2023.Two researchers screened the literatures according to the inclusion criteria and used Quality Assessment of Diagnostic Accuracy Studies(QUADAS)-2 scale to evaluate the literature quality.Meta-disc 1.4 software was applied for the meta-analysis.Results Seven literatures and 1620 clinical specimens were identified and included in the study.Meta-analysis showed that the pooled sensitivity,specificity,positive likelihood ratio and negative likelihood ratio of PCR for MPP diagnosis in children were 87%(95%CI 85%-89%),89%(95%CI 86%-92%),5.21(95%CI 2.85-9.52)and 0.19(95%CI 0.10-0.37)respectively.The area under the SROC curve(AUC)was 0.915,and the Q*index was 0.8476.Conclusion PCR application has the high sensitivity and specificity in the diagnosis of MPP in children,and can be used for the clinical diagnosis of MPP.

关 键 词：肺炎支原体肺炎 PCR 诊断 儿童 META分析 

分 类 号：R563.15[医药卫生—呼吸系统] R375.2[医药卫生—内科学]