引用本文:[点击复制]
[点击复制]
【打印本页】 【在线阅读全文】【下载PDF全文】 查看/发表评论下载PDF阅读器关闭

←前一篇|后一篇→

过刊浏览    高级检索

本文已被:浏览 14次   下载 14  
GeneXpert MTB/RIF对结核性脑膜炎诊断价值的 Meta分析
庞宇  张芸  梁清涛  杨新婷  段鸿飞  
0
()
摘要:
目的 系统评价 GeneXpert MTB/RIF 在结核性脑膜炎诊断中的应用价值。方法 通过计 算机检索 PubMed、Ovid、Embase、Scopus、Web of Science、Cochrane Library 及中国知网、维普数据库、万 方数据库等国内外数据库,收集建库至 2021 年 11 月发表的与 GeneXpert MTB/RIF 诊断结核性脑膜炎相 关的中英文文献。应用 RevMan 5.3 和 Meta-Disc 1.4 软件进行文献质量评价和 Meta 分析,计算汇总敏感 度、特异度、阳性似然比(PLR)、阴性似然比(NLR)、诊断比值比(DOR),绘制汇总受试者工作特征(SROC) 曲线并计算曲线下面积(AUC)。结果 共纳入 28 篇文献,共包含 5 137 例临床标本。Meta 分析显示, GeneXpert MTB/RIF 用于诊断结核性脑膜炎的汇总敏感度为 0.412(95%CI:0.392~0.431),特异度为 0.967 (95%CI:0.961~0.973)。以临床综合诊断标准为诊断标准,GeneXpert MTB/RIF 用于诊断结核性脑膜炎 的汇总敏感度和特异度分别为 0.362(95%CI:0.340~0.384)、0.973(95%CI:0.964~0.980);以结核分枝 杆菌培养为标准,GeneXpert MTB/RIF 诊断结核性脑膜炎的汇总敏感度和特异度分别为 0.589(95%CI: 0.547~0.630)和 0.961(95%CI:0.950~0.970)。脑脊液离心处理后,GeneXpert MTB/RIF 诊断结核性脑膜 炎的汇总敏感度和特异度分别为 0.431(95%CI:0.405~0.456)、0.966(95%CI:0.957~0.973)。HIV 感染情 况下,GeneXpert MTB/RIF诊断结核性脑膜炎的汇总敏感度为0.405(95%CI:0.375~0.434),特异度为0.967 (95%CI:0.956~0.976)。结论 脑脊液经离心处理后,GeneXpert MTB/RIF 检测对结核性脑膜炎有较高 的诊断价值,可作为快速诊断结核性脑膜炎的有效方法。
关键词:  结核  脑膜炎  GeneXpert MTB/RIF  诊断  Meta 分析
DOI:10.3969/j.issn.1009-6574.2022.06.008
基金项目:北京市临床重点专科项目;北京市卫生和计划生育委员会北京市卫生与健康科技成果 和适宜技术推广项目(2018-TG-43)
Meta-analysis of GeneXpert MTB/RIF in the diagnosis of tuberculous meningitis
Pang Yu,Zhang Yun,Liang Qingtao,Yang Xinting,Duan Hongfei
()
Abstract:
Objective To systematically investigate the diagnostic value of GeneXpert MTB/RIF essays in cerebrospinal fluid for tuberculous meningitis. Methods Relevant Chinese and English publications from the establishment of the database up to November 2021 about the diagnostic accuracy of GeneXpert MTB/RIF essays to tuberculous meningitis were searched in Pubmed,OVid, Embase, Scopus,Web of Science, Cochrane Library, CNKI,VIP and Wanfang databases. Then RevMan 5.3 and Meta-Disc 1.4 software were used to assess the quality of studies and conduct statistical analysis respectively. Sensitivity,specificity,positive likelihood ratio(PLR),negative likelihood ratio (NLR) and diagnostic odds of radio (DOR) were pooled. Summary receiver operating characteristic (SROC) curves and area under the curve (AUC) were calculated. Results A total of 28 articles were recruited, including 5 137 specimens from clinical patients. Meta-analysis showed that the pooled sensitivity and specificity of GeneXpert MTB/RIF essays for diagnosing tuberculous meningitis is 0.412 (95%CI: 0.392-0.431) and 0.967 (95%CI: 0.961-0.973) respectively.When using composite neference standard as the diagnostic standard,the pooled sensitivity and specificity is 0.362 (95%CI: 0.340-0.384) and 0.973 (95%CI:0.964-0.980).When using the culture of mycobacterium tuberculosis as the standard, the pooled sensitivity and specificity is 0.589 (95%CI: 0.547-0.630) and 0.961 (95%CI: 0.950-0.970). After centrifugation of cerebrospinal fluid, the pooled sensitivity and specificity is 0.431(95%CI: 0.405-0.456) and 0.966 (95%CI: 0.957-0.973). In the case of HIV infection, the pooled sensitivity and specificity is 0.405(95%CI:0.375- 0.434) and 0.967 (95%CI: 0.956-0.976). Conclusions GeneXpert MTB/RIF essays plays a valuable value in the diagnosis of tuberculous meningitis if the cerebrospinal fluid is centrifuged. It is recommended to diagnose tuberculous meningitis by using GeneXpert MTB/RIF essays in cerebrospinal fluid.
Key words:  Tuberculosis  Meningitis  GeneXpert MTB/RIF  Diagnosis  Meta-analysis

用微信扫一扫

用微信扫一扫