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目的系统评价抗原B ELISA(AgB ELISA)法对细粒棘球蚴病的诊断价值。方法计算机检索PubMed、EMbase、e Cochrane Library、EBSCO、CBM、CNKI、WanFang Data和超星Medalink数据库,并手工检索相关期刊,全面收集AgB ELISA法诊断细粒棘球蚴病的诊断性试验,检索时限从建库至2012年7月5日。由2位研究者按纳入与排除独立筛选文献、提取资料并按QUADAS标准评价纳入研究的方法学质量后,采用Meta-Disc 1.4软件进行Meta分析。结果最终纳入8个研究,包括562例经金标准确诊的细粒棘球蚴病患者,434例相似病例和303例健康人。8个研究间无阈值效应(灵敏度对数与1-特异度对数的Spearman相关系数=0.527,P=0.400 1),采用随机效应模型进行Meta分析结果显示,合并灵敏度、特异度、阳性似然比、阴性似然比及诊断比值比分别为0.76[95%CI(0.73,0.79)]、0.84[95%CI(0.82,0.86)]、5.20[95%CI(3.59,7.55)]、0.26[95%CI(0.18,0.35)]、23.93[95%CI(12.35,46.39)],SROC曲线下面积(AUC)=0.889 7,Q*=0.820 4。结论采用天然AgB和rAgB ELISA法检测细粒棘球蚴病具有较大诊断价值。
Objective To evaluate the diagnostic value of antigen B ELISA (AgB ELISA) in the diagnosis of echinococcosis granulosus. Methods The databases of PubMed, EMbase, EBSCO, CBM, CNKI, WanFang Data and Superstar Medalink were searched by computer. The related journals were searched by hand. The diagnostic test of AgB ELISA for diagnosis of Echinococcus granulosus was collected. The search time was from Construction of the library until July 5, 2012. Meta-analysis was performed on Meta-Disc 1.4 software by two investigators for inclusion and exclusion of independently screened documents, extraction of data, and evaluation of the methodology quality under inclusion in the QUADAS standard. Results The final study included 8 studies, including 562 patients with Echinococcus granulosus diagnosed by gold standard, 434 similar cases and 303 healthy individuals. There was no threshold effect among 8 studies (Spearman correlation coefficient between sensitivity logarithm and 1-specific logarithm = 0.527, P = 0.400 1). Meta-analysis using random effects model showed that the sensitivity, specificity and positive likelihood Odds ratio and diagnostic odds ratios were 0.76 [95% CI (0.73,0.79)], 0.84 [95% CI 0.82,0.86], 5.20 [95% CI 3.59,7.55], 0.26 [ 95% CI (0.18,0.35)], 23.93 [95% CI (12.35,46.39)], area under the SROC curve (AUC) = 0.889 7, Q * = 0.8204. Conclusion The detection of natural swine echinococcosis by AgB and rAgB ELISA is of great diagnostic value.