卡介菌纯蛋白衍生物和结核菌素纯蛋白衍生物在结核病筛查中差异对比的Meta分析

Meta analysis of the differences between BCG-PPD and TB-PPD in tuberculosis screening

为探讨卡介菌纯蛋白衍生物(BCG-PPD)和结核菌素纯蛋白衍生物(TB-PPD)在结核病筛查中的差异。笔者检索PubMed、Embase、Medline、Cochrane Library、中国知网和万方数据库从建库至2022年2月期间发表的相关文献,对符合纳入条件的文献采用Open Meta Analyst软件进行Meta分析,采用Rev Man 5.3软件Cochrane偏倚风险评估工具对文献进行质量评价。最终纳入7篇文献,共36131例参与者,BCG-PPD组参与者18314例,TB-PPD组参与者17817例。采用二分类随机效应模型进行分析,合并的OR(95%CI)值为2.072(1.683~2.550),I^(2)=78.73%,P<0.001,存在高度异质性,需要进一步分析异质性的来源。亚组分析结果显示,以学生及新生儿为研究对象的亚组OR(95%CI)值为2.393(2.132~2.686),I^(2)=50.15%,P=0.091,I^(2)值明显下降;以结核病患者为研究对象的亚组OR(95%CI)值为0.481(0.236~0.978),I^(2)=0,P=0.043,选用固定效应模型。可见,TB-PPD和BCG-PPD在不同人群结核病筛查中存在阳性检出率的差异,以学生及新生儿为研究对象,BCG-PPD的阳性检出率高于TB-PPD;以结核病患者为研究对象,TB-PPD的阳性检出率高于BCG-PPD。

To investigate the differences between pure protein derivative of BCG(BCG-PPD)and pure protein derivative of tuberculin(TB-PPD)in tuberculosis screening.Relevant literatures published from the establishment of the databases to February 2022 were searched from PubMed,Embase,Medline,Cochrane Library,CNKI and Wanfang.Open Meta Analyst software was used for meta-analysis of the included literatures.Cochrane Risk of Bias Assessment tool with Rev Man 5.3 software was used to evaluate the quality of the literature.Finally,7 articles were included,with a total of 36131 participants,including 18314 participants in BCG-PPD group and 17817 participants in TB-PPD group.Dichotomous random effect model was used to analyzed.The combined OR(95%CI)value was 2.072(1.683-2.550),I^(2)=78.73%,P<0.001,indicating high heterogeneity,and the source of heterogeneity should be further analyzed.The results of subgroup analysis showed that the OR(95%CI)value of students and newborns was 2.393(2.132-2.686),I^(2)=50.15%,P=0.091,and I^(2)value decreased significantly.The OR(95%CI)value of tuberculosis patients in the subgroup was 0.481(0.236-0.978),I^(2)=0,P=0.043,and the fixed-effect model was used.Differences in the positive detection rate of TB-PPD and BCG-PPD in different populations were found.The positive detection rate of BCG-PPD is higher than that of TB-PPD in students and neonates,and the positive detection rate of TB-PPD was higher than that of BCG-PPD in tuberculosis patients.