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目的评价抗聚丝蛋白抗体(AFA)对类风湿性关节炎(RA)诊断的准确性。方法计算机检索PubMed(1966～2010.8)、Cochrane Library(2010年第8期)、EMbase(1974～2010.8)、中国生物医学文献数据库(1978～2010.8)、CNKI(1994～2010.8)、VIP(1989～2010.8)和中华医学会数字化期刊库(1997～2010.8)等,并追索纳入研究的参考文献,查找AFA与修订的RA分类标准(ACR)比较诊断类风湿性关节炎的诊断性试验,依据QUADAS质量评价标准评价纳入研究的质量,采用Meta-Disc 1.4软件进行Meta分析。结果共纳入18篇文献,6 971例受试者。Meta分析结果显示:与ACR相比,AFA诊断RA的合并敏感度、特异度、阳性似然比、阴性似然比、诊断OR值和SROC分别为0.52(0.50,0.54)、0.93(0.92,0.94)、7.11(5.35,9.45)、0.53(0.48,0.60)、13.82(9.93,19.24)和0.8347。结论应用免疫印迹和ELISA法检测AFA时,其对RA的诊断效能高,有一定的临床应用前景。
Objective To evaluate the diagnostic accuracy of antifibroblast antibody (AFA) for rheumatoid arthritis (RA). Methods We searched PubMed (1966 ~ 2010.8), Cochrane Library (2010), EMbase (1974 ~ 2010.8), China Biomedical Literature Database (1978 ~ 2010.8), CNKI ) And the Chinese Medical Association Digitized Journal Library (1997 ~ 2010.8), etc., and recalled the references included in the study to find out the diagnostic test of rheumatoid arthritis with AFA and revised RA classification criteria (ACR). According to QUADAS quality Evaluation criteria The quality of the included studies was evaluated using Meta-Disc 1.4 software for meta-analysis. Results A total of 18 articles were included, 6 971 subjects. Meta analysis showed that the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic OR and SROC of RAA were 0.52 (0.50,0.54), 0.93 (0.92,0.94 ), 7.11 (5.35, 9.45), 0.53 (0.48, 0.60), 13.82 (9.93, 19.24) and 0.8347. Conclusion When using AFB and ELISA to detect AFA, its diagnostic value for RA is high and it has certain clinical application prospects.