糖化血红蛋白检测用于妊娠糖尿病诊断的meta分析

The diagnostic performance of glycosylated hemoglobin measurement for gestational diabetes mellitus:a mata-analysis

目的评价糖化血红蛋白(HbA1c)检测在妊娠糖尿病的诊断中的价值。方法检索PubMed、Ovid、Springer数据库、中国期刊全文数据库、维普数据库和万方数据库中的相关文献,根据纳入和排除标准筛选文献,然后提取纳入文献的反应诊断性能的特征信息。数据采用Meta-Dise1.4和SPSS12.0软件进行统计分析,检验各研究结果的异质性,并根据异质性检验结果选择相应效应模型,综合评价诊断优势比、灵敏度、特异度、似然比和汇总受试工作者特征曲线(SROC)的曲线下面积(AUC)等指标。结果共纳入18篇文献,经异质性检验为同质,采用固定效应模型作meta分析,得到合并诊断优势比、敏感度、特异度、阳性似然比和阴性似然比分别为159.02(95%CI:110.70～228.43)、0.83(95%CI:0.81～0.86)、0.97(95%CI:0.96～0.98)、26.20(95%CI:19.39～35.41)和0.17(95%CI:0.15～0.20),SROCAUC=0.9740,Q*=0.9265。结论 HbA1c检测是一种可以用于妊娠糖尿病诊断的敏感、特异、快速、简便的方法。

Objective To evaluate the validity of glycosylated hemoglobin measurement in the diagnosis of gestational diabetes mellitus. Methods Pertinent literature retrieval was performed in PubMed,Ovid,Springer Database,China Academic Journals Full- Text database, VIP database and Wanfang database. Literature was selected according to the selecting criteria, from which the data indicated the diagnostic performance was extracted. Then the data was analyzed by software Meta-Disel. 4 and SPSS12.0. Appro- priated effects mode was selected to analyse diagnostic odds ratio,sensitivity, specificity,likelihood ratio,the area under the SROC curve and other indexs,according to the results of tests for heterogeneity. Results 18 articles were included in the study and the homogeneous tests indicated no statistically significance. Therefore, the data was analyzed by meta-analysis with the fixed-effects model,the summarized diagnostic odds ratio, sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were 159.02（95%CI：110.70-228.43）0.83（95%CI0.81-0.86）0.97（95%CI0.96-0.98）26.20（95%CI：19.39-35.41） and 0.17（95%CI：0.15-0. 20） ,respectively. The SROC AUC was 0. 974 0 and Q＊ was 0. 926 5. Conclusion HbAlc mesurment is a sensitive, specific, rapid and convenient methord for the diagnosis of gestational diabetes mellitus.