多重荧光定量PCR方法在呼吸道合胞病毒和腺病毒检测中的Meta分析

Multiplex real time polymerase chain reaction technique in detection of respiratory syncytial virus and adenovirus： a Meta analysis

目的通过Meta分析评价多重荧光定量PCR（multiplex real time polymerase chain reaction，MRT—PCR）方法在呼吸道病毒中常见呼吸道合胞病毒（respiratory syncytial virus，RSV）和腺病毒（adenovirus，ADV）感染的诊断价值，为临床应用提供参考。方法检索数据库包括PubMed、EMBASE、Cochrane、万方、CNKI等，检索2010年1月至2018年1月关于MRT—PCR方法检测呼吸道病毒感染的中英文文献，由2位研究者独立筛选文献、提取资料，并采用QUADAS-2工具评价纳人研究的偏倚风险后，采用Meta—disc1．4对数据进行统计分析。结果本研究纳入10篇文献共2528例样本。Meta分析结果显示，MRT—PCR检测RSV的Sen合并=0．87（95％CI：0．83—0．90）、Spe合并=0．98（95％CI：0．97—0．98）、AUC=1．00。MRT—PCR检测ADV的Sen合并=0．64（95％CI：0．56—0．71）、Spe合并=0．99（95％CI：0．98—0．99）、AUC=0．99、Q=0．96。Deeks漏斗图检验结果提示无明显的发表偏倚。结论MRT-PCR方法检测RSV和ADV的灵敏度有待提高，但检测综合能力较好，对临床上呼吸道病毒感染的早期诊断具有一定的应用价值。

Objective To systematically review the diagnostic accuracies of multiplex real time polymerase chain reaction （MRT-PCR） technique for detection of respiratory syncytial virus （RSV） and adenovirus （ADV）. Methods PubMed, EMBASE, Cochrane, Wanfang and CNKI databases were searched from Januaryl 2010 to Januaryl 2018, to collect repoIts on MRT-PCR for detection of common respiratory viruses. Then two authors independently exacted the data and assessed the risk of bias of included studies by using the QUADAS-2 tool. Meta-disc 1.4. Results Ten articles with 2528 cases were eligible for analysis. The result of recta-analysis showed that, the pooled Sen, Spe and area under SROC curve, for detecting RSV were 0.87 （95% C10. 83 to 0.90） , 0.98 （95% CI 0. 97 to 0. 98） and 1.00. The pooled Sen, Spe, and area under SROC curve of MRT-PCR for detecting ADV were 0.64 （95% CIO. 56 to 0.71 ） ,0.99 （95% CI 0.98 to 0.99） and 0.99. Deeks test indicated that no publication bias was found. Conclusions The sensitivity of MRT-PCR in RSV and ADV detection is still to be improved, but the overall detection ability is good which deserves to be recommended for clinical use.