呼出气一氧化氮对支气管哮喘诊断价值的荟萃分析

发布时间：2018-02-28 01:15

本文关键词： 呼出气一氧化氮 FENO 哮喘诊断　出处：《山西医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：采用荟萃分析的方法，评价呼出气一氧化氮（FENO）诊断支气管哮喘（哮喘）的准确性。方法：检索Pubmed、the cochrane library,the embase以及中国知网数据库，全面收集探讨FENO诊断哮喘的相关文献，采用诊断试验质量评价（QUADAS）工具对入选文献进行质量评价，通过Deeks法在STATA（12.0）软件中检测是否具有发表偏倚，提取四格表相关数据，使用Meta-Disc （1.4）软件对其进行异质性检验，并进行异质性回归分析，最后合并灵敏度、特异度、阳性似然比、阴性似然比、诊断比值比等各项指标，计算AUC值，并描绘综合受试者工作特征曲线。结果：共有16篇文献总计19项研究入选，入选文献总体质量评价较高，其中某些文献质量较低的原因主要集中于QUADAS工具的条目1、3、4、11，即研究对象的入选、金标准的具体方案、待评价试验和金标准之间的时间间隔、是否使用盲法等方面。纳入的各项研究基本不存在发表偏倚(即bias其p=0.3540.05）。异质性分析显示敏感度、特异度等各项指标的p值均明显小于0.05，即各研究间具有异质性，回归分析后未找出异质性原因，故采用随机效应模型合并各统计指标，，最终得出敏感度、特异度、阳性似然比、阴性似然比、诊断比数比的数值依次为61%、82%、3.87、0.39、10.78，AUC值为0.8175。结论：FENO诊断哮喘的敏感度较低，特异性和总体诊断效能中等。在临床上，FENO可用于辅助诊断哮喘、减少哮喘的漏诊以及降低支气管激发试验的风险。
[Abstract]:Objective: to evaluate the diagnostic accuracy of exhaled nitric oxide (FENO) in bronchial asthma (Asthma) by meta-analysis. Methods: the relevant literature on FENO diagnosis of asthma was collected by searching Pubmedthe cochrane library#en0# the embase and China knowledge net database, and the selected literatures were evaluated by using the diagnostic test quality evaluation tool (QUADASA). The Deeks method was used to detect publication bias in Stata 12.0) software. The data of four tables were extracted, the heterogeneity was tested by Meta-Disc 1.4) software, and the heterogeneity regression analysis was carried out. Finally, sensitivity, specificity, positive likelihood ratio were combined. The negative likelihood ratio and diagnostic ratio ratio were used to calculate the AUC value and to depict the integrated operating characteristic curve of the subjects. Results: a total of 19 studies of 16 articles were selected, and the overall quality of the selected literature was evaluated high. The reasons for the lower quality of some documents were mainly focused on the entry of QUADAS tool, I. e., the selection of the study subjects and the specific scheme of the gold standard. The time interval between the test to be evaluated and the gold standard, whether the blind method was used or not. There was basically no publication bias in the various studies included (i.e., bias, p0.3540.05). Heterogeneity analysis showed sensitivity. The p value of each index, such as specificity, was obviously less than 0.05, that is, there was heterogeneity among the studies, but the reason of heterogeneity was not found after regression analysis, so the random effect model was used to combine the statistical indexes, and finally the sensitivity, specificity, positive likelihood ratio were obtained. The value of negative likelihood ratio and diagnostic ratio were 61and 82in turn, and the AUC value was 0.8175.The value of AUC was 0.8175.The value of AUC was 3.87 ~ 0.39 ~ 10.78%. Conclusion the sensitivity, specificity and overall diagnostic efficacy of FENO are low, and FENO can be used to assist the diagnosis of asthma, reduce the risk of missed diagnosis of asthma and reduce the risk of bronchial provocation test.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R562.25

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