AMA及其M2亚型对PBC诊断价值的Meta分析
发布时间:2018-06-06 07:22
本文选题:抗线粒体抗体 + 抗线粒体抗体M2亚型 ; 参考:《重庆医科大学》2014年硕士论文
【摘要】:背景:原发性胆汁性肝硬化(primary biliary cirrhosis, PBC)是一种自身免疫性疾病,病因尚不清楚,其发病率呈上升趋势。PBC患者的诊断对其预后至关重要。而抗线粒体抗体(anti-mitochondrial antibody,AMA)阳性被美国肝病研究学会(AASLD)列为PBC的诊断标准之一。 目的:系统评价AMA及其M2亚型对PBC的诊断价值。 方法:建立检索策略,搜索PubMed (Medline)、Cochrane图书馆、中国知网和维普中文科技期刊数据库,收集所有与AMA及其M2亚型对PBC诊断相关的研究文献与资料。根据纳入和排除标准筛选原始研究文献,并用QUADAS质量评价量表对纳入文献进行严格评估;收集、提取、总结必要的数据信息,使用Review Manger5.2和MetaDiSc1.4软件对纳入文献进行汇总与统计描述;根据异质性检验结果选择合适的合并效应量估计模型与方法,进行统计推断。敏感性分析评估Meta分析结果的真实性与稳健性。 结果:纳入文献24篇:包括19篇英文文献,5篇中文文献;病例组样本量为2992例。异质性检验结果提示存在异质性(非阈值效应),,故采用随机效应模型合并统计量。Meta分析结果显示:不同方法检测AMA的汇总灵敏度为84.5%(95%CI,83.3% 85.6%),汇总特异度为97.8%(95%CI,97.6% 98.0%),汇总阳性似然比为25.201(95%CI,17.583 36.118),汇总阴性似然比为0.162(95%CI,0.131 0.199)。 结论:AMA和AMA-M2亚型对PBC的诊断具有较高诊断价值,但相对于AMA-M2亚型来说,AMA具有更全面更高的诊断效能。
[Abstract]:Background: primary biliary cirrhosis, PBC) is an autoimmune disease with primary biliary cirrhosis. The anti-mitochondrial antibody anti-body AMA positive was identified as one of the diagnostic criteria for PBC by the American Society for the study of liver Disease (ASLD). Objective: to evaluate the diagnostic value of AMA and M 2 subtype in PBC. Methods: a search strategy was established to search the PubMed Medline and Cochrane Library, the Chinese Journal of Science and Technology database, and to collect all the literature and data related to the diagnosis of PBC by AMA and its M2 subtype. According to the criteria of inclusion and exclusion, the original research documents were screened, and the QUADAS quality evaluation scale was used to evaluate strictly the included documents, to collect, extract and summarize the necessary data information. The Review Manger5.2 and MetaDiSc1.4 software are used to summarize and describe the literature, and according to the results of heterogeneity test, appropriate models and methods for estimating the combined effect quantity are selected, and the statistical inference is carried out. Sensitivity analysis was used to evaluate the authenticity and robustness of Meta results. Results: 24 articles were included, including 19 English articles and 5 Chinese literatures, the sample size of the case group was 2992 cases. The results of heterogeneity test indicated heterogeneity (non-threshold effect), so the random effect model was used to combine statistics. Meta-analysis results showed that the aggregate sensitivity of different methods for detecting AMA was 83.3% and 85.3%, and the aggregation specificity was 97.895% CII 97.6% and 98.0% respectively. The sex likelihood ratio is 25.201 ~ 95% and the sum negative likelihood ratio is 0.162 ~ 95% ~ 0.131 ~ 0.199. ConclusionAMA and AMA-M2 subtypes have higher diagnostic value for PBC, but they are more effective than AMA-M2 subtypes.
【学位授予单位】:重庆医科大学
【学位级别】:硕士
【学位授予年份】:2014
【分类号】:R575.2
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