摘要
目的评价抗Ⅱ型胶原抗体对类风湿性关节炎(RA)诊断的准确性。方法计算机检索PubMed、EMBASE、Cochrane Library、CBMWeb、CSJD、CJFD等数据库,全面收集抗Ⅱ型胶原抗体对RA诊断试验的文献,依据QUADAS质量评价标准评价纳入诊断试验的质量,对结果进行Meta分析。结果最终纳入文献5篇,包括1 293个受试者。Meta分析结果显示,抗Ⅱ型胶原抗体对RA诊断的合并敏感度为0.43(0.40,0.47),合并特异度为0.89(0.87,0.91),合并阳性似然比为6.70(3.21,13.97),合并阴性似然比为0.62(0.49,0.78),合并诊断比值比为12.75(4.66,34.86),受试者工作特性曲线下面积0.7974,Q=0.7336。结论抗Ⅱ型胶原抗体对RA诊断的敏感度较低,特异度较高,结合临床不推荐抗Ⅱ型胶原抗体用于RA的初筛及常规检查,可用于确诊高度疑似病例或症状体征不明显,经金标准无法诊断的患者。
Objective To evaluate the diagnostic value of anti-collagen Ⅱ （anti-C Ⅱ） antibody for rheumatoid arthritis （RA）. Methods A fully recursive literature review was conducted in PubMed, EMBASE, Cochrane Library, CBMWeb, CSJD, CJFD. The quality assessment of diagnostic accuracy study items were used to evaluate the quality included in diagnosis tests. Meta-disc software was used to handle data from included tests. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and summary receiver operating characteristic curve （SROC） were used to assess the diagnostic value of individual diagnostic tests. Results A total of 5 research papers and 1 293 patients were included. The summary sensitivity and summary specificity were 0.43 （0.40, 0.47）, 0.89 （0.87, 0.91）. The summary positive likelihood ratio and summary negative likelihood ratio were 6.70 （3.21, 13.97）, 0.62 （0.49, 0.78）, the square under the SROC curve was 0.7974 and Q was 0.7336. Conclusion Anti-C Ⅱ antibodies are low to the sensitivity of diagnosis of RA but high to the specificity. In clinical treatment, anti-C Ⅱ antibodies are not recommended for the screen of RA. Anti-C Ⅱ antibodies can be used for confirmed or highly suspected cases, or for the patients without obvious symptoms and signs who can not be classified in the standard by the American College of Rheumatology.
出处
《兰州大学学报（医学版）》
CAS
2010年第3期17-20,共4页
Journal of Lanzhou University（Medical Sciences）
