论文部分内容阅读
目前的国际结核病(TB)指南推荐在对肺结核可疑患者评价时应用3次痰涂片镜检以寻找结核菌。我们对符合3次痰标本结果标准的研究进行了系统的评价。通过对多个数据库和资源的检索,我们确定了共37个合格的研究。第3份标本中涂阳结果的增加(所有培阳病例作为分母的研究)和敏感性的增高(所有培阳病例作为分母的研究)是我们关注的主要结果。虽然各研究的方法和结果不同对数据综合构成了挑战,但亚组的分析提示对第3份标本的检查使结果和/或敏感性平均增加了2%～ 5%。把推荐的标本检查数量从3份减至2份(特别是在同一天收集的2份标本)对结核控制项目有利。有很多理由可潜在增加病例检出;许多实施性研究问题需要强调。如果按照国际间协调和标准化的方法,在痰标本镜检时应用现行技术检验哪种方法最有效,这样的研究会是最有用的,既可以增加本国的数据,又可进行研究之间的对比。
Current guidelines for international tuberculosis (TB) recommend using sputum smear microscopy three times in the evaluation of suspicious cases of tuberculosis in search of M. tuberculosis. We conducted a systematic review of studies that met the criteria of 3 sputum sample results. Through the retrieval of multiple databases and resources, we identified a total of 37 eligible studies. The main result of our concern is the increase in smear-positive results (all studies of positive cases of Pei-Yang as a denominator) and the increase in sensitivity (all cases of Pei-Yang as a denominator) in the third specimen. Although differences in the methods and outcomes of the studies pose a challenge to data synthesis, the subgroup analysis suggests that an examination of the third specimen resulted in an average increase in outcome and / or sensitivity of 2% to 5%. Reducing the number of recommended specimen examinations from 3 to 2 (in particular, 2 specimens collected on the same day) is beneficial to tuberculosis control programs. There are many reasons to potentially increase case detection; many implementation research issues need to be emphasized. It is most useful if the current technique is used to test which method is the most effective in microscopic examination of sputum based on the international harmonization and standardization method, which can not only increase the data of the country but also compare the studies .