摘要
目的通过meta分析评价抗中性粒细胞胞质抗体(ANCA)、抗酿酒酵母细胞抗体(ASCA)对成人炎症性肠病(IBD)亚组的诊断价值。方法通过国内外各大数据库检索ANCA、抗ASCA与成人溃疡性结肠炎、克罗恩病(CD)相关的文献,采用QUADAS-2量表评价纳入文献质量,利用meta-disc计算异质性及合并敏感度、特异度、阳性似然比、阴性似然比及诊断比值比,并绘制受试者工作曲线。结果按照纳入及排除标准共有13项独立研究入选meta分析,用metadisc1.4软件联合ANCA诊断溃疡性结肠炎、ASCA诊断克罗恩病的总敏感度、特异度、阳性拟然比、阴性拟然比、诊断比值比、受试者工作曲线下面积分别为0.51、0.92、6.06、0.53、12.56、0.79、0.56、0.92、5.13、0.57、10.33、0.82。结论 ANCA、ASCA有利于IBD亚组的诊断,临床表现疑似的首诊患者可先行该检查,血清标志物阳性者给予早期治疗,阴性后再完善结肠镜检。该思路对增加依从性、疾病预后均具有重要意义。
Objective To assess diagnosis value of detecting ANCA and ASCA on adult IBO subgroups. Methods Through searching literatures involving in correlations between ANCA,ASCA and adult colitis gravis and Crohn′s disease(CD) in and aboard,adopting the QUADAS—2 scale to assess the quality of the literatures included and metadisc heterogeneous computing , The combined sensitivity,specificity,positive likelihood ratio,negative likelihood ratio as well as the diagnostic odds ratio,the curve of the testees was drawn. Results In line with the inclusion and exclusion standards ,13 independent studies were considered. The pooled sensitivity,specificity,positive and negative likehood ratio,diagnostic odds ratio and area under curve (AUC) in diagnosis of colitis gravis by ANCA with meta—disc1.4 software were 0.51,0.92,6.06,0.53,12.56,0.79,0.56,0.92,5.13, 0.57,10.33,0.8169 accordingly and those of and CD by ASCA being 0.56,0.92,5.13,0.57,10.33,0.82 successively. Conclusion ANCA and ASCA are beneficial to the diagnosis of IBD subgroups. The suspected patients in clinic may select this examina—tions. Those whose serum markers are positive may treated as early as possible ,the others who are negative may choose the colonoscopy examination. The thought is subject to major significance i improving the compliance and prognosis. More prospec—tive,double—blind,large—size samples were required to verify its clinical value further.
出处
《现代医药卫生》
2015年第7期972-976,共5页
Journal of Modern Medicine & Health
关键词
抗体
抗中性白细胞胞质
酵母菌
酿酒
敏感性与特异性
炎性肠疾病
META分析
Antibodies,antineutrophil cytoplasmic
Saccharomyces cerevisiae
Sensitivity and specificity
In-flammatory bowel disease
Meta-analysis