脑脊液非螺旋体抗原试验对神经梅毒诊断功效率系统评价.pdfVIP

脑脊液非螺旋体抗原试验对神经梅毒诊断功效率系统评价 大连市皮肤病医院 乐宏元 张振国 占城 苏宗义 【摘要】目的 系统评价脑脊液非螺旋体抗原试验对神经梅毒的诊断效率。方法 采用 Cochrame系统评价方法检索电子数据库中公开发表的脑脊液非螺旋体抗原试验（VDRL、RPR、 TRUST）的研究文献及参考文献，制订纳入和排除标准，提取被纳入研究文献的数据，采用 MetaDisc1.4分析软件进行统计分析。结果 6个研究符合纳入标准被纳入本次系统评价，含 神经梅毒CSF样品225例，非梅毒患者CSF样品1224例。Spearman相关系数为-0.03(p=0.957)， 各研究间不存在阈值效应。加权合并功效指标及95%置信区间（CI）分别为：敏感度 0.773(0.713～0.826)、特异性 0.988(0.980～0.993)、阳性似然比 53.5(24.3～118.0)、阴性似 然比 0.233(0.180～0.296)、诊断优势比229.9(117.3～450.9)、综合受试者工作特征曲线下面 积 0.981及Q指数0.938。按方法分组进行Meta回归分析：RDOR=1.07[95%CI:0.19-5.96] 。结 论：脑脊液非螺旋体抗原试验对神经梅毒有较高的诊断功效，RPR 和TRUST可替代VDRL用于 脑脊液样品。 【关键词】 RPR TRUST VDRL 脑脊液 Meta分析 神经梅毒 ThePerformanceofNon-treponemalTestsinCerebrospinalFluidforThe DiagnosisofNeurosyphilis:AMetaAnalysis YUEhongyuan,ZHANGzhenguo,ZHANcheng,SUZONGzongyiTheDalianDermatologyHospital, Dalian116021,China 【Abstract】Objective To evaluate the Performance of non-treponemal tests in cerebrospinal fluid for the diagnosis of neurosyphilis. Methods：Two reviewers independently retrievedthe literatures for CSF non-treponemal tests published in Electronicdatabase and assessed quality ofthe studies. Entrycriteria includedthe assessmentforCSFnon-treponemaltestscurrentlyusedinclinicalpractice,andthe usedofstandardcriteriafor bothdiagnosisandexclusionof neurosyphilis. Primary outcomes were sensitivity and specificity of the CSF non-treponemaltests. Result: Of 14 unique citations, 6 studies meet the criteria were included in the systematic review. Of these, 1449 of cases were observed. Due to non significant heterogeneity among studies, we were to generate pooled summary statistics, using fixed effects model. Sensitivity were 0.773 (0.713~0.826), specificity were 0.988 (0.980~0.993), positive likelihood ratio were 53.5 (24.3~118.0), negative likelihood ratio were 0.233 (0.180~0.296), diagnostic odds ratios were 229.9 (117.3~450.