HIV感染者CD_4^+T淋巴细胞数与总淋巴细胞计数相关性的Meta分析

Correlation between CD_4^+ T cell count and total lymphocyte count in HIV-infected patients: A meta-analysis

目的根据艾滋病病毒(Human immunodeficiency virus,HIV)感染者的总淋巴细胞计数(Total lyopho-cyte count,TLC)预测CD4+T淋巴细胞计数<200个/μL的值进行系统评价。方法检索中英文文献,并根据纳入标准对文献进行筛选。利用Meta-DiSc 1.4和Stata/SE 12.0软件,对纳入的研究结果按不同的TLC临界值分别进行合并灵敏度、特异度、阳性预测值、阴性预测值的计算,绘制不同临界值的综合受试者工作特征曲线,计算曲线下面积并进行比较。结果共筛选文献12篇,按TLC临界值分别为1 200个/μL、1 300个/μL、1 400个/μL及1500个/μL进行Meta分析。以TLC<1 200个/μL预测CD4<200个/μL的合并灵敏度和特异度分别为0.62[95%可信区间(Confidence interval,CI):0.60～0.64]和0.81(95%CI:0.80～0.82)。不同TLC临界值下的综合受试者工作特征曲线下面积不相同,但差异无统计学意义。结论以TLC<1 200个/μL预测CD4<200个/μL时准确性最高,此结果与世界卫生组织的建议一致。

Objective To systematically review the value of total lymphocyte count （TLC） for predicting CD4＋ T lymphocyte count 〈 200 cells/μL in HIV/AIDS patients. Methods The related articles in English and Chinese literature were searched. Eligible. studies were selected if the inclusion criteria were met. Meta-DiSc 1.4 and Stata/ SE 12. 0 were used to calculate the performance measures, including the pooled sensitivity, specificity, positive predictive value and negative predictive value under different TLC thresholds. The summary receiver operating characteristic （SROC） curves were drawn and the areas under the curves were calculated and compared. Results Twelve articles in English and Chinese were eligible for inclusion. Meta-analysis was conducted when the thresholds of TLC were set at 1 200 eeUs/μL, 1 300 cells/μL, 1 400 cells/μL and 1 500 eeIls/μL, respectively. When using TLC〈1200 cells/μL for predicting CD4〈 200 cells/μL, the pooled sensitivity and specificity were 0.62 （95% CI： 0. 60- 0.64） and 0. 81 （95% CI： 0.80-0.82）, respectively. The areas under the SROC curves for the four TLC thresholds were not different statistically. Conclusion The predictive performance of TLC 〈 1 200 cells/μL for predicting CD〈 200 cells/μL is the highest among those of other TLC thresholds, which is the same as the TLC threshold that the World Health Organization has recommended.