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目的通过对酶联免疫斑点试验(Enzyme linked immunospot assay,Elispot)与血清结核抗体检测试验(tuberculosis antibody,TB-AB)在菌(涂)阴肺结核诊断中的灵敏度和特异度优势比进行Meta分析,评价Elispot用于菌阴肺结核的诊断价值。方法计算机检索中文期刊全文数据库、万方医学网、维谱数据库、Pubmed、Elsevier Science等数据库,获取符合标准的10篇文献为研究对象,采用Stata12.0与Meta Disc1.4计算Elispot、TB-AB用于菌(涂)阴肺结核辅助诊断灵敏度与特异度的优势比,并获得Elispot合并后的灵敏度和特异度。结果 Elispot用于菌(涂)阴肺结核辅助诊断的合并灵敏度为87.4%(95%CI 83.3%-90.6%)、特异度为84.5%(95%CI 80.3%-88.0%);Elispot较之TB-AB的灵敏度优势比为OR=5.75(95%CI 3.38-9.83)、特异度优势比为OR=2.44(95%CI 1.55-3.83)。结论 Elispot阳性结果对于菌(涂)阴活动性结核病的辅助诊断价值与阴性结果对于活动性肺结核的排除诊断能力较TB-AB具备明显比较优势。
OBJECTIVE: To analyze the sensitivity and specificity odds ratio of tuberculous bacterial smear-negative pulmonary tuberculosis by Enzyme linked immunospot assay (Elispot) and tuberculosis antibody (TB-AB) Evaluation of the diagnostic value of Elispot for bacterial vaginosis. Methods We searched 10 databases of Chinese journals, Wanfang medical network, Weiwei database, Pubmed, Elsevier Science and other databases for Elspot, TB-AB It is used to detect the odds ratio of the sensitivity and specificity of bacteriocin-negative pulmonary tuberculosis and obtain the combined sensitivity and specificity of Elispot. Results Elispot had a combined sensitivity of 87.4% (95% CI 83.3% -90.6%) and a specificity of 84.5% (95% CI 80.3% -88.0%) for bacteriostatic detection of negative pulmonary tuberculosis. Compared with TB- The odds ratio for AB was OR = 5.75 (95% CI 3.38-9.83). The odds ratio for AB was OR = 2.44 (95% CI 1.55-3.83). Conclusion The diagnostic value and negative result of Elispot positive results for the detection of active bacilli (TB) negative TB have a clear comparative advantage over TB-AB in the diagnosis of active tuberculosis.