我国疟疾诊断试验准确性的Meta分析

发布时间：2018-06-29 01:07

本文选题：疟疾 + 诊断试验　；参考：《中国病原生物学杂志》2017年03期

【摘要】：目的通过诊断试验Meta分析,定量综合评价我国聚合酶链反应技术(PCR)、快速诊断试剂盒(RDTs)、环介导等温扩增技术(LAMP)等疟疾诊断试验的诊断效果。方法根据检索策略,检索CNKI、万方数据、维普、PUBMED、PMC等数据库,初筛出公开发表的关于疟疾诊断试验的文献,按照纳入与排除标准,纳入符合条件的文献,进行文献质量评价并提取相关数据,采用SPSS20、RevMan5.3和MetaDiSc1.4绘制漏斗图、森林图和SROC曲线。结果有57篇文献符合纳入标准,效应量合并分析结果显示PCR法检测疟疾的综合灵敏度为0.99(0.98-0.99),特异度为0.96(0.95-0.97),SROC曲线下面积为0.994 3,诊断优势比为1056.20(408.08-2 733.68)。RDTs法检测恶性疟的综合灵敏度为0.93(0.92-0.94),特异度为0.99(0.98-0.99),SROC曲线下面积为0.995 5,诊断优势比为657.30(365.22-1 182.95);检测间日疟的综合灵敏度为0.91(0.89-0.92),特异度为0.99(0.98-0.99),SROC曲线下面积为0.990 0,诊断优势比为656.17(348.21-1 236.51)。LAMP法检测恶性疟的综合灵敏度为0.93(0.88-0.97),特异度为0.98(0.94-1.00),SROC曲线下面积为0.951 5,诊断优势比为293.72(77.27-1 116.55);检测间日疟的综合灵敏度为0.98(0.96-0.99),特异度为0.94(0.88-0.97),SROC曲线下面积为0.996 3,诊断优势比为1 072.50(237.16-4 850.09)。结论聚合酶链反应技术(PCR)、快速诊断试剂盒(RDTs)、环介导等温扩增技术(LAMP)对疟疾的诊断准确性均较高,但各有差异,其中用RDTs检测恶性疟的诊断准确性比检测间日疟高。
[Abstract]:Objective to evaluate the diagnostic efficacy of polymerase chain reaction (PCR) rapid diagnostic kit (RDTs) and loop mediated isothermal amplification (lamp) by meta analysis. Methods according to the retrieval strategy, CNKI, Wanfang data, PUBMEDMC and other databases were searched, and the published literature on malaria diagnosis test was initially screened. According to the criteria of inclusion and exclusion, the eligible documents were included. Literature quality was evaluated and relevant data were extracted. The funnel map, forest map and SROC curve were drawn by SPSS20 RevMan5.3 and MetaDiSc1.4. Results 57 articles met the inclusion criteria. The results of combination analysis showed that the overall sensitivity of PCR for malaria detection was 0.99 (0.98-0.99), the specificity was 0.96 (0.95-0.97) and the area under the SROC curve was 0.994 3. The diagnostic odds ratio was 1056.20 (408.08-2 733.68) .RDTs was 0.93 (0.92-0.94) for falciparum malaria, and 0.99 (0.98-0.99) for the area under the SROC curve. The diagnostic odds ratio was 657.30 (365.22-1 182.95), the overall sensitivity of vivax malaria was 0.91 (0.89-0.92), the specificity was 0.99 (0.98-0.99) and the area under the SROC curve was 0.990. The diagnostic odds ratio was 656.17 (348.21-1 236.51) .lamp was 0.93 (0.88-0.97), and the area under the SROC curve was 0.98 (0.94-1.00). The diagnostic odds ratio of vivax malaria was 293.72 (77.27-1 116.55), the overall sensitivity of vivax malaria was 0.98 (0.96-0.99), the specificity was 0.94 (0.88-0.97), the area under SROC curve was 0.996 3, and the diagnostic odds ratio was 1 072.50 (237.16-4 850.09). Conclusion the diagnostic accuracy of polymerase chain reaction (PCR), rapid diagnostic kit (RDTs) and cyclic mediated isothermal amplification (lamp) is higher than that of vivax malaria. The diagnostic accuracy of RDTs for falciparum malaria is higher than that for vivax malaria.
【作者单位】：云南省寄生虫病防治所云南省疟疾研究中心云南省虫媒传染病防控研究重点实验室;云南省普洱卫生学校;
【基金】：云南省中青年学术技术带头人后备人才项目(No.2015HB075)
【分类号】：R531.3

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