HLA-B27对中国人群强直性脊柱炎诊断价值的Meta分析

Diagnostic Value of HLA-B27 Tests for Ankylosing Spondylitis in Chinese Population:A Meta-analysis

目的探讨HLA-B27对中国人群强直性脊柱炎(AS)的诊断价值。方法计算机检索Pub Med、EMbase、The Cochrane Library(2015年8期)、CNKI以及WanFang Data数据库,搜集国内外发表的关于HLA-B27诊断中国人群AS的诊断性试验,检索时限均从建库至2015年8月。由2位研究者独立筛选文献、提取资料和评价纳入研究的方法学质量后,采用Stata 12.0软件进行统计分析。结果共纳入16个研究,共计3 137例AS患者,5 617例疑似AS患者。Meta分析结果显示,HLA-B27诊断AS的Sen_(合并)=0.91[95%CI(0.89,0.93)]、Spe_(合并)=0.94[95%CI(0.91,0.96)]、+LR_(合并)=14.90[95%CI(9.60,23.10)]、–LR_(合并)=0.09[95%CI(0.08,0.12)]、DOR_(合并)=157[95%CI(90,275)]、AUC=0.95[95%CI(0.93,0.97)]。结论 HLA-B27检测对中国人群AS诊断价值较高。基于现有研究的缺陷,本研究结论尚需开展更多长期随访的前瞻性研究予以证实。

Objective To explore the diagnostic value of HLA-B27 for ankylosing spondylitis （AS） in Chinese population. Methods We searched PubMed, EMbase, The Cochrane Library （Issue 8, 2015）, CNKI, and WanFang data from inception to August 2015, to collect diagnostic studies about HLA-B27 for AS in Chinese population. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then meta- analysis was performed by using Statal2.0 software. Results A total of 16 studies involving 3 137 AS and 5 617 suspect patients were finally included. The results ofmeta-analysis showed that the pooled Sen, Spe, ＋LR, -LR and DOR were 0.91 （95%CI 0.89 to 0.93）, 0.94 （95%CI 0.91 to 0.96）, 14.90 （95%CI 9.60 to 23.10）, 0.09 （95%CI 0.08 to 0.12） and 157.00 （95%CI 90.00 to 275.00）, respectively. The AUC of SROC was 0.98 （95%CI 0.93 to 0.97）. Conclusions HLA-B27 detection is of great diagnostic value for AS in Chinese population. However, due to the limited quality and quantity of the included studies, more long-term follow-up prospective studies are needed to verify the above conclusion.