γ-干扰素释放试验鉴别肠结核与克罗恩病的临床价值

发布时间：2018-01-05 13:22

本文关键词：γ-干扰素释放试验鉴别肠结核与克罗恩病的临床价值　出处：《重庆医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:系统评价两种不同的γ-干扰素释放试验(interferon-γreleasing assay,IGRA)对鉴别肠结核(intestinal tuberculosis,ITB)和克罗恩病(Crohn’s disease,CD)的诊断价值。方法:计算机检索Embase、PubMed、EBM Reviews、相关期刊论文、万方数字化期刊全文数据库,查找评价IGRA在ITB与CD鉴别诊断价值的文献,时间是建库至2016年1月,对纳入的文献进行质量评价,采用Meta-Disc 1.4软件进行Meta分析,分别汇总2种IGRA的敏感度、特异度及95%可信性区间(95%confidence interval,95%CI)。根据汇总受试者工作特征曲线(summary reciever operating characteristic,SROC),计算曲线下面积(area under curve,AUC),得出各自的Q*值,评价不同方法的诊断价值。结果:共纳入12篇文献,总病例数854例(ITB 367例,CD 487例)。结核感染T淋巴细胞斑点试验(T SPOT tuberculosis,T-SPOT.TB)的汇总敏感度和特异度分别为0.89(95%CI=0.84~0.93)、0.85(95%CI=0.81~0.89)。结核杆菌T淋巴细胞检测(QuantiFeron tuberculosis,QuantiFeron-TB)的汇总敏感度和特异度分别为0.72(95%CI=0.64~0.79)、0.92(95%CI=0.86~0.96)。两组的SROC曲线下面积分别为0.9450,0.9110。两者Q*值分别为0.8839、0.8432,比较两组Q*值,差异无统计学意义(P=0.164)。结论:T-SPOT与QuantiFeron-TB在鉴别ITB与CD上有较高的敏感度、特异度,准确率高,是鉴别ITB与CD的有效辅助手段,两者诊断准确性差异比较无统计学意义。
[Abstract]:Objective: To evaluate two kinds of interferon gamma release test (interferon- gamma releasing assay, IGRA) in the differential diagnosis of intestinal tuberculosis (intestinal, tuberculosis, ITB) and Crohn's disease (Crohn 's disease, CD) diagnostic value. Methods: We searched Embase, PubMed, EBM, Reviews, Chinese CNKI, Wanfang digital periodical full-text database, search literature evaluation value of IGRA in differential diagnosis of ITB and CD, the time is up to January 2016, to evaluate the quality of the included studies. Meta analysis was performed using Meta-Disc 1.4 software, 2 IGRA summary of sensitivity, specificity and 95% confidence intervals (95%confidence, interval, 95%CI) according to the summary. The receiver operating characteristic curve (summary reciever operating characteristic, SROC), calculate the area under the curve (area under, curve, AUC), the respective Q* values, different methods to evaluate the diagnostic value of Value. Results: a total of 12 articles were included, the total number of cases in 854 cases (ITB 367 cases, CD 487 cases). Tuberculosis infection T lymphocytes (T SPOT spot test tuberculosis, T-SPOT.TB) of the pooled sensitivity and specificity were 0.89 (95%CI=0.84~0.93), 0.85 (95%CI=0.81~0.89). The detection of TB (T lymphocyte QuantiFeron tuberculosis, QuantiFeron-TB) of the pooled sensitivity and specificity were 0.72 (95%CI=0.64~0.79), 0.92 (95%CI=0.86~0.96). SROC curve area in two groups were both 0.9450,0.9110. Q* values were compared between the two groups of 0.8839,0.8432, Q* value, the difference was not statistically significant (P=0.164). Conclusion: T-SPOT and QuantiFeron-TB are higher in the differential ITB and CD on the sensitivity, specificity, accuracy, is an effective auxiliary means of identification of ITB and CD, the diagnostic accuracy of the difference was not statistically significant.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R524;R574.62

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