IIF法检测血清抗cmDNA抗体诊断SLE价值的系统评价

Systematic review of using anti-cmDNA antibodies to diagnose the SLE by IIF

目的评价间接免疫荧光法（IIF）检测血清中抗细胞膜DNA（cmDNA）抗体诊断系统性红斑狼疮（SLE）的价值。方法检索1970—2009年PubMed、中国期刊全文数据库，检索词为：系统性红斑狼疮、SLE、自身抗体、细胞膜DNA，收集关于抗cmDNA抗体诊断SLE价值的相关研究文献，根据Whiting等制定的QUADAS文献质量评价工具对文献进行质量评价，使用MetaDisc1．4进行异质性分析、Meta分析及绘制SROC曲线。结果共纳入文献7篇，合计2447例，其中经金标准确认的SLE患者共824例。Meta分析异质性检验辟0．0009，F=73．5％；合并敏感度为69．0％，95％CI为66．0％～72．0％；合并特异度为97．0％，95％CI为96．0％-98．0％；合并阳性似然比＋LR=21．37，95％CI为12．17—37．54；合并阴性似然比-LR=0．28，95％CI为0．18～0．45；SROC曲线下面积AUC=0．9336（SE=0．0607）。结论目前间接免疫荧光法检测血清中抗cmDNA抗体诊断SLE有一定的价值，可作为诊断SLE的特异性指标。

Objective To evaluation the signifacance of anticell membrane associated DNA （ cmDNA ） antibodies in systemic lupus erythematosus （ SLE ） by indirect immunofluorescence （ IIF ）. Methods We searched PubMed and full-text data base of Chinese periodical to identify studies on the diagnostic value of anti-cell membrane associated DNA antibody in patients with SLE. The searching time was from 1970 to 2009. The key words are systemic lupus erythematosus , SLE and autoantibody. Select those valid researches. Performed a systematic reviem of outcomes about laboratory diagnosis for SLE by using Meta-discl.40. MetaDisc was used to analyze heterogeneity, perform meta-analyses and draw sum- mary receiver operator characteristic cmwe （ SROC ）.Results The resultes of recta-analysis showed that there was high heterogeneity in the 7 rasearches , the sensitivity and specificity was 69.0% and 97.0v＆ the positive likelihood （ ＋LR ） and negative likelihood （ -LR ） was 21.37and 0.28 ; the area under the curve （ AUC ） was 0.9336. Conclusion The autnantibodies to cmDNA by IIF can be used as a special index in diagnosing the SLE.