摘要
目的许多研究发现胸腔积液中腺苷脱氨酶(ADA)有助于结核性胸膜炎的早期诊断。我们拟通过此次荟萃分析以确定ADA对结核性胸膜炎的诊断价值。方法对英文文献进行系统评价,用随机效应模型汇总各研究中ADA诊断结核性胸膜炎的灵敏度、特异度以及其它指标,绘制汇总受试者工作特征曲线并探讨其诊断特性。结果按照选择标准最终有61项独立研究纳入本次荟萃分析,ADA诊断结核性胸膜炎的总体灵敏度0.92(95%可信区间为0.91～0.93);特异度0.90(0.89～0.91);阳性似然比8.82(7.05～11.04),阴性似然比0.10(0.07～0.14);诊断优势比:105.15(68.38～167.89)。结论ADA诊断结核性胸膜炎的灵敏度、特异度均较高,测量胸腔积液中的ADA有助于诊断结核性胸膜炎。分析ADA测定结果应该与临床所见以及常规检验结果相结合。
Objective Many studies have investigated the usefulness of adenosine deaminase（ADA） in pleural fluid for the early diagnosis of tuberculous pleurisy.We performed a meta-analysis to determine the accuracy of ADA measurements in the diagnosis of tuberculous pleurisy.Methods After a systematic review of English language studies,sensitivity,specificity,and other measures of accuracy of ADA concentrations in the diagnosis of tuberculous pleural effusion were pooled using random effects models.Summary receiver operating characteristic curves were used to summarize overall test performance.Results Sixty one studies met our inclusion criteria.The summary estimation for ADA in the diagnosis of tuberculous pleurisy in the studies included were：sensitivity 0.92（95% confidence interval 0.91～0.93）,specificity 0.90（0.89～0.91）,positive likelihood ratio 8.82（7.05～11.04）,negative likelihood ratio 0.10（0.07～0.14）,and diagnostic odds ratio 105.15（68.38～167.89）.Conclusions ADA determination is a sensitive and specific test for the diagnosis of tuberculous pleurisy.Measurement of ADA in pleural effusion is thus likely to be a useful diagnostic tool for tuberculous pleurisy.The results of ADA assays should be interpreted in parallel with clinical findings and the results of conventional tests.
出处
《内科》
2007年第5期718-723,共6页
Internal Medicine
基金
国家自然科学基金(30660064)
广西自然科学基金(0639044)项目共同资助
