免疫过滤法、平板双向扩散法、酶联免疫吸附试验法血清学检验技术对农民肺诊断价值的Meta分析

Electrosyneresis、ouchterlony double diffusion、ELISA in diagnosing of farmer's lung with Meta analysis

目的通过Meta分析评价免疫过滤法、平板双向扩散法、酶联免疫吸附试验法对农民肺的诊断价值。方法收集1960年1月至2010年12月国内外以临床表现、体格检查、影像学及肺功能改变、纤维支气管镜检查为金标准确诊农民肺,并以血清学检验技术免疫过滤法、平板双向扩散法、酶联免疫吸附试验法诊断农民肺的相关文献。采用Review Manager 5.0、Meta-Disc 1.4软件,检验异质性,根据异质性结果选择相应效应模型,计算合并灵敏度和合并特异度,合并阳性似然比、合并阴性似然比、DOR值及其95%CI。绘制综合受试者工作特征曲线、计算曲线下面积综合评价各血清学方法的诊断效能。结果 5篇文献符合纳入标准。合并敏感性和特异性后,免疫过滤法表现出最高的敏感性(78%)和相对较高的特异性(84%);平板双向扩散法特异性虽高(86%)但敏感性较低(70%);酶联免疫吸附试验法敏感性(76%)、特异性(53%)均较低;绘制综合受试者工作特征曲线、计算曲线下面积显示免疫过滤法AUC值(0.904 4)、Q*(0.836 0)高于平板双向扩散法(AUC=0.8543,Q*=0.7853)及酶联免疫吸附试验法(AUC=0.719 7,Q*=0.668 7)。结论血清学技术是一种很好的农民肺诊断手段;免疫过滤法、平板双向扩散法血清学技术对农民肺诊断效能较高。

Objective To investigate the value of electrosyneresis,ouchterlony double diffusion,ELISA in diagnosing of farmer＇s lung with Meta analysis.Methods Articles of electrosyneresis、ouchterlony double diffusion、ELISA on farmer＇s lung published in English or Chinese from 1960 to December 2010 were collected,took clinical manifestation,physical examination,iconography and lung function,fiberoptic bronchoscope as golden standards.The software of Revman 5.0 and Metadisc 1.4 were used for calculated the sensitivity,specificity,summary receiver operating characteristic curves,area under the curve and the heterogenerty.Results 5 articles accord with the internalize standard.The sensitivity[0.78（0.59-0.90）] and DOR[23.56（4.62-120.01）] of ouchterlony double diffusion is higher than the electrosyneresis and elisa;the electrosyneresis had the highest AUC（0.9044） and Q＊（0.836 0）.Conclusion The electrosyneresis and ouchterlony double diffusion are two useful serum diagnostic toll for detecting farmer＇s lung.