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目的用Meta分析综合评价Xpert结核分枝杆菌/利福平(MTB/RIF)法对我国肺结核病诊断价值。方法通过对Pubmed、Embase、中国知网、维普数据库、万方数据库等进行文献检索,查找应用Xpert MTB/RIF诊断结核病的文献,摘录相关数据,应用Stata12和Revman5.2软件对所纳入的文献进行Meta分析,并对其发表偏倚进行评估。结果共纳入7篇文献进行分析。Xpert MTB/RIF法诊断肺结核的合并敏感度为93%(95%CI:91%~94%),合并特异度为81%(95%CI:79%~83%)。4篇文献分别分析了Xpert MTB/RIF法对涂片阳性和阴性结果的差异,对涂片阳性病例敏感度和特异度分别为98%(95%CI:96%~99%)、特异度为88%(95%CI:86%~91%),涂片阴性病例敏感度和特异度分别为73%(95%CI:64%~81%)、特异度79%(95%CI:77%~82%)。Xpert MTB/RIF法诊断利福平耐药结核病的敏感度为90%(95%CI:86%~94%)、特异度98%(95%CI:93%~99%)。结论 Xpert MTB/RIF法对我国基层防治机构结核病诊断具有一定价值,在利福平检测方面具有较好的应用前景。
Objective To evaluate the diagnostic value of Xpert Mycobacterium tuberculosis / rifampicin (MTB / RIF) in our country for the diagnosis of pulmonary tuberculosis using Meta analysis. Methods The literature search of Pubmed, Embase, CNKI, VIP database and Wanfang database was used to search for the literature of Xpert MTB / RIF diagnosis of tuberculosis. The relevant data were extracted. Stata12 and Revman5.2 software were used for the literature review Meta-analysis and assess publication bias. Results A total of 7 articles were included in the analysis. The combined sensitivity of Xpert MTB / RIF for the diagnosis of pulmonary tuberculosis was 93% (95% CI: 91% -94%) and the combined specificity was 81% (95% CI: 79% -83%). Four articles separately analyzed the difference of smear positive and negative results by Xpert MTB / RIF method. The sensitivity and specificity of smear-positive cases were 98% (95% CI: 96% -99%) and specificity The sensitivity and specificity of smear-negative cases were 73% (95% CI: 64% -81%) and 79% (95% CI: 86% -91% ~ 82%). The sensitivity of Xpert MTB / RIF in the diagnosis of rifampicin-resistant TB was 90% (95% CI: 86% -94%) and 98% (95% CI: 93% -99%). Conclusion The Xpert MTB / RIF method has some value in the diagnosis of tuberculosis in primary prevention and control institutions in our country, and has a good application prospect in the detection of rifampicin.