基于循证医学方法评价妊娠肝内胆汁淤积症生物标志物的诊断价值

发布时间：2019-03-29 13:05

【摘要】：目的:基于Meta分析结果,运用综合受试者工作特征曲线技术(summary receiver operating characteristic,SROC)5种技术方法评价妊娠肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)中总胆汁酸(total bile acid,TBA)的诊断价值。方法:检索中文数据库:中国生物医学文献数据库(CBM)、万方、CNKI;英文数据库:Pub Med,High Wire,Ovid,the Cochrane Library,Google scholar research。文献搜索的截至日期为2015年5月。对所纳入的文献进行质量评价和数据提取后,利用Meta分析所收集的TBA的灵敏度、特异度等数据信息,运用双变量随机效应模型的SROC 5种方法:ηonξ、ξonη、D on S、RG(Rutter and Gatsonis)、主轴法,应用SAS的MIXED和NLMIXED过程步得到参数,建立5种模型,评价TBA对ICP的诊断价值。结果:通过Meta分析检索步骤,最终纳入6篇文献,根据5种方法计算出诊断评价结果曲线下面积(area under curve,AUC)值显示:ηonξ:0.711,ξonη:0.448;D on S:0.730;RG:0.801;主轴法:0.703,提示TBA的诊断准确性较高,而5种技术方法的AUC和SROC图形结果显示:RG评价TBA准确性的效果较其他方法更好。结论:TBA诊断ICP的准确性较好,但RG的效果评价需进一步验证。
[Abstract]:Aim: to evaluate the diagnostic value of total bile acid (total bile acid,TBA) in intrahepatic cholestasis of pregnancy (intrahepatic cholestasis of pregnancy,ICP) by five techniques based on the results of Meta analysis and comprehensive receiver operating characteristic curve (summary receiver operating characteristic,SROC) technique. Methods: Chinese database: (CBM), Wanfang, CNKI; English database: Pub Med,High Wire,Ovid,the Cochrane Library,Google scholar research. The deadline for literature search is May 2015. After the quality evaluation and data extraction of the included documents, the sensitivity and specificity of the collected TBA were analyzed by Meta, and five methods of SROC of the bivariate random effect model were used: 畏 on 尉, 尉 on 畏, D on S, RG (Rutter and Gatsonis),. Using SAS's MIXED and NLMIXED process steps to get parameters, five models were established to evaluate the diagnostic value of TBA for ICP. Results: by means of Meta analysis and retrieval steps, six literatures were included. According to five methods, the area (area under curve,AUC under the curve of diagnostic evaluation results was calculated. The results showed that 畏 on 尉: 0.711, 尉 on 畏: 0.448 D on S = 0.730; RG:0.801; spindle method: 0.703, which indicated that the diagnostic accuracy of TBA was higher than that of other methods. The results of AUC and SROC showed that RG was more effective than other methods in evaluating the accuracy of TBA. The results of AUC and SROC showed that RG was more effective than other methods in evaluating the accuracy of TBA. Conclusion: the accuracy of TBA in the diagnosis of ICP is good, but the evaluation of the effect of RG should be further verified.
【作者单位】：重庆医科大学公共卫生与管理学院卫生统计与信息管理教研室;
【基金】：国家自然科学基金资助项目(编号:81373103) 重庆市自然科学基金资助项目(编号:cstc2013jcyj A0068)
【分类号】：R714.25;R-03

【参考文献】