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脑脊液单核细胞内早期分泌性抗原靶-6诊断结核性脑膜炎的系统评价

发布时间:2018-03-21 21:49

  本文选题:结核性脑膜炎 切入点:早期分泌性抗原靶-6 出处:《广西医科大学》2013年硕士论文 论文类型:学位论文


【摘要】:目的:系统评价脑脊液(CSF)单核细胞内早期分泌性抗原靶-6(ESAT-6)诊断结核性脑膜炎(TBM)的价值; 方法:计算机检索PubMed、EMbase、Cochrane图书馆、中国医学文献数据库、中国知网、维普数据库及万方数据库的关于脑脊液单核细胞内ESAT-6诊断结核性脑膜炎的中文及英文文献,检索时间截至2012年12月。由两名评价者按照纳入和排除标准选择文献、依据QUADAS质量评价标准评价纳入研究的质量后,提取资料,采用Meta-disc1.4软件对纳入文献进行异质性检验及数据分析,通过合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比及受试者工作特征曲线(SROC曲线)等统计指标综合评价ESAT-6对结核性脑膜炎的诊断价值。 结果:共纳入7篇文献,样本含量为482例,其中诊断为结核性脑膜炎的患者为243例。异质性检验显示各研究结果间无明显异质性,通过固定效应模型的汇总计算得出:合并敏感度0.84(95%,CIO.79-0.89),合并特异度0.93(95%,0.89-0.96),阳性似然比(PLR)11.75(95%,7.43-18.58),阴性似然比(NLR)0.16(95%,0.12-0.22),诊断比值比(DOR)71.65(95%,38.69-132.70), SROC曲线下面积(AUC)0.9528。 结论:ESAT-6可作为诊断结核性脑膜炎较重要的参考指标之一。
[Abstract]:Objective: to evaluate the value of early secretory antigen target 6 (ESAT-6) in the diagnosis of tuberculous meningitis (TBM) in cerebrospinal fluid (CSF) monocytes. Methods: the Chinese and English literatures on the diagnosis of tuberculous meningitis with intracellular ESAT-6 in cerebrospinal fluid (CSF) were searched on PubMedus Embase Cochrane Library, Chinese Medical Literature Database, China knowledge Network, Weip Database and Wanfang Database. The retrieval time was up to December 2012. Two evaluators selected the literature according to the inclusion and exclusion criteria, and then extracted the data according to the QUADAS quality evaluation criteria. The heterogeneity test and data analysis were carried out by using Meta-disc1.4 software. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and negative likelihood ratio were combined, and the negative likelihood ratio was analyzed by combining sensitivity, specificity, positive likelihood ratio and negative likelihood ratio. The diagnostic value of ESAT-6 in the diagnosis of tuberculous meningitis was evaluated synthetically by the diagnostic ratio ratio and the operating characteristic curve of the subjects. Results: a total of 7 articles were included, and the sample size was 482, including 243 patients diagnosed as tuberculous meningitis. The heterogeneity test showed that there was no significant heterogeneity among the results of the study. Through the summary calculation of fixed effect model, it was found that the combined sensitivity was 0.84 ~ 95g / CIO.79-0.89, the combined specificity was 0.939 ~ 0.96, the positive likelihood was 7.43-18.58, the negative likelihood ratio was 0.16950.12-0.22, the diagnostic ratio was 71.659595 / 38.69-132.70, and the area under SROC curve was 0.9528. Conclusion: ESAT-6 can be used as an important index in the diagnosis of tuberculous meningitis.
【学位授予单位】:广西医科大学
【学位级别】:硕士
【学位授予年份】:2013
【分类号】:R529.3

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