摘要
目的系统评价T细胞酶联免疫斑点试验(T-SPOT.TB)、结核菌素皮肤试验(TST)在儿童结核性疾病中的诊断价值。方法在中国知网、万方、Medline、Cochrane Library、PubMed、Embase数据库检索已发表的关于不同结核菌感染检测方法应用于儿童结核性疾病诊断的相关文献,截止日期为2018年10月31日。筛选出不同结核菌感染检测方法在结核性疾病患儿中的阳性率,对纳入的文献进行质量评价和资料提取。使用Meta-Disc 1.4、RevMan 5.3和Stata 15.1进行Meta分析。使用Meta-disc1.4软件进行敏感度和特异度分析,并绘制综合受试者工作特征曲线(SROC),采用RevMan 5.3内置的QUADAS-2评价工具对纳入文献质量进行评价;采用Stata15.1进行发表偏倚的检验,并绘制Deeks漏斗图。结果共纳入15篇研究文献。结果显示,T-SPOT.TB的汇总敏感度为89%[95%可信区间(CI):87%~91%],汇总特异度为95%(95%CI:93%~96%);TST检验的汇总敏感度为66%(95%CI:63%~70%),汇总特异度为70%(95%CI:66%~73%)。结论T-SPOT.TB较TST敏感度和特异度更高,在儿童结核性疾病中具有较高的诊断价值。
Objective To systematically evaluate the diagnostic value of T-SPOT.TB test and tuberculin skin test(TST)in tuberculous disease in children.Methods Studies on the diagnosis of tuberculous disease in children by different detection methods,which were published before October 31,2018,were searched in databases including CNKI,Wanfang Data,PubMed,and EMBASE.The positive rates of different test methods for children with tuberculous disease were collected,and methodology quality evaluation and data extraction were performed.Meta-Disc 1.4,RevMan 5.3,and Stata 15.1 were used to carry out the meta-analysis.Meta-disc1.4 software was used for sensitivity and specificity analysis,and the summary receiver operating characteristic(SROC)curves were plotted.QUADAS-2 in RevMan 5.3 software was used to evaluate the quality of the articles.Stata 15.1 was used to test publication bias and Deeks funnel plot was drawn.Results Fifteen studies were included in this study.Meta-analysis showed that the pooled sensitivity and specificity of T-SPOT.TB test were 89%(95%CI:87%-91%)and 95%(95%CI:93%-96%),respectively,and those of TST were 66%(95%CI:63%-70%)and 70%(95%CI:66%-73%),respectively.Conclusion Compared with TST,T-SPOT.TB has a higher sensitivity and specificity and therefore has higher diagnostic value in tuberculous disease in children.
作者
陈巧佩
丁营
Chen Qiaopei;Ding Ying(Clinical Laboratory,Guangxi Maternal and Child Health Hospital,Nanning 530003,China;Department of Epidemiology and Health Statistics,Statistics College of Renmin University of China,Beijing 100872,China)
出处
《中华临床医师杂志（电子版）》
CAS
2020年第2期129-135,共7页
Chinese Journal of Clinicians(Electronic Edition)
基金
广西壮族自治区妇幼保健院育苗计划青年项目(GXWCH-YMJH-2017009)
广西壮族自治区卫生健康委员会自筹课题(Z20190876)。
