γ-干扰素释放试验在鉴别肠结核与克罗恩病临床价值的系统评价

发布时间：2018-05-02 08:44

本文选题：肠结核 + 克罗恩病　；参考：《重庆医科大学学报》2015年10期

【摘要】：目的:系统评价2种不同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、Pub Med、EBM Reviews、相关期刊论文(CNKI)、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,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(summery 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.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(Quanti Feron-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)。2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2组Q*值,差异无统计学意义(P=0.164)。结论:T-SPOT与Quanti Feron-TB是鉴别ITB与CD的有效辅助手段,两者诊断准确性差异无统计学意义。
[Abstract]:Objective: to evaluate the diagnostic value of two different interferon- 纬 releasing IGRAs in the differential diagnosis of intestinal tuberculosis (ITB) and Crohns disease (CDCD). Methods: Embase Pub MedIGRA EBM Reviews, China Journal Full-text Database and Wanfang Digital Journal Full-text Database were searched on the computer to find the documents evaluating the value of IGRA in the differential diagnosis of ITB and CD, and to evaluate the quality of the included documents. The sensitivity, specificity and 95% dependability of the two kinds of IGRA were collected by Meta analysis with Meta-Disc 1.4 software. According to the summery reciever operating characteristic curve, the area area under the curve under curveAUC is calculated, and their Q * values are obtained to evaluate the diagnostic value of different methods. Results: a total of 12 articles were included, the total number of cases was 854 cases with ITB 367 cases with CD 487 cases. The total sensitivity and specificity of T-SPOT.TB were 0.8995, respectively. The total sensitivity and specificity of Mycobacterium tuberculosis T lymphocyte detection for Quanti Feron-TB were 0.72 95, respectively. The area under the SROC curve was 0.9450 ~ 0.9110 in the 0.86 ~ 0.86 ~ 0.96 ~ 9 ~ 2 group, respectively. The Q* values of the two groups were 0.8839 and 0.8432.There was no significant difference between the two groups. Conclusion: t-spot and Quanti Feron-TB are effective assistant methods for differentiating ITB from CD, and there is no significant difference in diagnostic accuracy between them.
【作者单位】：重庆医科大学附属第一医院消化内科;
【分类号】：R574.62

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