Meta分析评价AMPLICOR检测系统对结核病的诊断价值

Evaluation of AMPLICOR Test in diagnosis of tuberculosis by Meta analysis

目的用Meta分析综合评价AMPLICOR检测系统对结核病的诊断价值。方法搜索Medline数据库,检索用AMPLICROR检测系统诊断结核病的文献,摘录相关数据。数据分析用Sigmaplot软件绘制SROC曲线,用Cochrane工作组的Revman4．2软件进行Meta分析,用非参数检验比较不同金标准和不同标本类型对结果的影响。结果共获得到文献42篇,AMPLICOR检测系统诊断结核病敏感性81．2％,特异性96．0％,22篇文献分别分析了AMPLICOR检测系统对涂片阳性和阴性结果的差异,对涂片阳性病例敏感性97．0％,特异性76．6％,涂片阴性病例敏感性62．2％,特异性99．3％,采用不同金标准和不同标本类型DOR(Diagnostic Odd Ratio)有显著差异。结论AMPLICROR检测系统不仅对菌阳结核病,对菌阴结核病也具有一定诊断价值。影响试验结果的因素包括金标准的类型、菌阳标本所占比例、呼吸道标本所占比例等。

Objective To evaluate the value of AMPLICOR test in the diagnosis of tuberculosis by meta analysis. Methods We searched Medline database and screened the papers related to diagnosis of tuberculosis by AM PLICOR test, and then drew the summary receiver operating characteristie（SROC）by Sigmaplot, and analyzed data by Revman 4.2（a software from Coehrane）. Finally, we compared DOR（Diagnostie Odd Ratio） of different golden standard and different sample types by nonparametric test. Results The data from 42 papers were analyzed. It showed that the sensitivity and specificity of AMPLICOR test were 81.2% and 96.0%, respectively. Tweenty-two papers were analyzed on the sensitivity and specificity of AMPLICOR test for smear-positive eases（sensitivity 97%, specificity 76.6% ）and smear-negative eases（sensitivity 62.2%, specificity 99.3% ）. There were significant difference of DOR on using different golden standard and different sample types. Condusion AMPLICOR test might be useful for the diagnoses of the smear-positive tuberculosis and smear-negative tuberculosis.