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结核分枝杆菌耐异烟肼诊断试验的系统评价

Diagnostic Value of all Diagnostic Tests for Detecting Armazide Resistance in Mycobacterium Tuberculosis: A Systematic Review

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【作者】 张君雨田金徽姜雷张颖杨孙虎于红娟杨克虎

【Author】 ZHANG Jun-yu1, TIAN Jin-hui2, JIANG Lei2, ZHANG Yin3,4, YANG Sun-hu2, YU Hong-juan3, YANG Ke-hu21.Gansu Center for Disease Control and Prevention, Lanzhou 730000, China;2.Evidence-based Medicine Center of Lanzhou University, Lanzhou 730000, China;3.Tuberculosis Research Center of Lanzhou University, Lanzhou 73000, China4.The Health Public School of Hopkins University, Washington 074100, U.S.A

【机构】 甘肃省疾病预防控制中心兰州大学循证医学中心兰州大学结核病研究中心美国霍普金斯大学隆博格公共卫生学院

【摘要】 目的评价9种检测结核分枝杆菌耐异烟肼诊断试验方法的准确性。方法计算机检索PubMed、EMbase等数据库和手工检索相关期刊,全面收集结核分枝杆菌耐异烟肼诊断试验的研究,依据QUADAS评价纳入诊断试验的质量,并对结果进行Meta分析。结果最终纳入12个研究。Meta分析结果显示:硝酸盐还原法与比例法相比,以及BACTECMGIT960与BACTEC460TB相比,其敏感度、特异度、阳性似然比、阴性似然比及SROC曲线下面积分别为92%、99%、31.84、0.12、0.9836和98.5%、96%、13.66、0.035、0.9871;其余检测方法,如MODS、MB/BacT、MYDBA和TTC亦显示了较好的敏感度和特异度。结论硝酸盐还原检测法可代替比例法作为结核分枝杆菌耐异烟肼的筛查试验。BACTECMGIT960可代替BACTEC460检测系统作为结核分枝杆菌耐异烟肼的确诊试验。

【Abstract】 Objective To evaluate the diagnostic value of all diagnostic tests for detecting armazide resistance in mycobacterium tuberculosis. Methods We searched PUBMED, EMBASE, CBM, CSJD and CJFD. QUADAS items were used to evaluate the quality of included studies. Meta-disc software was used to handle data from included studies. Results Twelve studies were included. Meta-analyses showed that the summary sensitivity and summary specificity of nitrate reductase assay were 92% and 99%, and those of BACTEC MGIT 960 system were 93% and 96%, respectively. The SROC of nitrate reductase assay and BACTEC MGIT 960 system were 0.9836 and 0.9862, respectively. Conclusion We recommend that proportion method can be replaced by nitrate reductase assay as a screening test for detecting armazide resistance in mycobacterium tuberculosis, and BACTEC 460 can be replaced by BACTEC MGIT 960 system as a final diagnostic test for detecting armazide resistance in mycobacterium tuberculosis.

【基金】 甘肃省科技攻关计划资助项目(0708NKCA110)
  • 【文献出处】 中国循证医学杂志 ,Chinese Journal of Evidence-Based Medicine , 编辑部邮箱 ,2008年10期
  • 【分类号】R446.5
  • 【下载频次】259
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