类风湿关节炎相关抗体实验室检测文献初步评价

Systematic evaluation of the published reviews about rheumatoid arthritis associated antibody

目的运用循证检验医学的研究方法对类风湿关节炎(RA)相关抗体的实验室检测已发表的文献进行初步评价。方法利用Cochrane系统评价专用软件Revman4.2并结合循证检验学特点进行Meta分析。结果Anti-CCP、IgM-RFs均有较高的阳性检出率,但两者间的阳性检出率差异没有显著性(P>0.05)。AKA对于RA的阳性检出率相对最低。IgA-RF与Anti-CCP的阳性检出率差异无显著性(P>0.05)。Anti-CCP比AKA阳性检出率高(P<0.001),IgM-RFs比AKA阳性检出率高(P<0.001),IgM-RFs比IgA-RFs阳性检出率高(P<0.001),IgA-RFs比AKA阳性检出率高(P<0.001)。结论对于RA而言,Anti-CCP、IgM-RFs、IgA-RF具有较高的阳性检出率,但对RA的实验室诊断方案需进一步研究。

[Objective] To assess the published reviews about rheumatoid arthritis （RA） associated antibody with approach of evidence based laboratory medicine. [Methods] To assess the related 19 reviews of RA with soft Cochrane Revman 4.2 and meta-analysis. [Results] The positive predictive value of Anti-CCP and IgM-RFs was similar （P 〉0.05） and their diagnostic specificity was higher than others. The positive predictive value of AKA was lower than others. There was no obviously difference between IgA-RFs and Anti-CCP in positive predictive value （P 〉0.05）. There were difference between Anti-CCP and AKA, IgM-RFs and AKA, IgM-RFs and IgA-RFs, IgA-RFs and AKA in positive predictive value （P 〈0.001）, respectively. [Conclusions] The measurement of Anti-CCP, IgM- RFs and IgA-RFs was useful for the diagnosis of patients with RA, but it was valuable to research laboratory diagnosis program of RA.