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目的评价抗环瓜氨酸肽(CCP)抗体在类风湿关节炎(RA)中的临床诊断价值。方法检索2000年1月至2005年12月Cochrane图书馆、PubMed数据库、EMBASE数据库、OVID循证医学数据库、中国生物医学文献数据库,并专门检索Ann Rheum Dis及相关灰色文献,按照Cochrane协作网推荐的诊断试验的纳入标准筛选文献,应用MATLAB软件、Review Manager 4．2软件及“调整SROC法”对纳入研究进行综合定量评价。结果共纳入22篇中英文文献,抗-CCP抗体对RA诊断的敏感度范围为39．2％～84．6％,特异度范围为90％～97．9％;纳入研究存在异质性,按照随机效应模型计算汇总加权灵敏度和特异度及95％可信区间分别为77．3％(63．1％,89．2％)和93．85％(85．5％, 98．1％),相应的阳性似然比和阴性似然比为12．0和0．24;拟合SROC曲线下面积为0．8976,Q值为0．87;进一步对病程小于1年和大于1年汇总分析,病程小于1年或病程大于1年研究层定量合并灵敏度和特异度分别为43％、94．2％和70．2％、95．2％,合并进行层间比较灵敏度差异有统计学意义(P<0．001)而特异度差异无统计学意义(P=0．94)。结论抗-CCP抗体诊断RA的灵敏度、特异度均较高,在综合考虑可能影响评价结果的前提下,对临床诊断有指导作用。目的评价抗环瓜氨酸肽(CCP)抗体在类风湿关节炎(RA)中的临床诊断价值。方法检索2000年1月至2005年12月Cochrane图书馆、PubMed数据库、EMBASE数据库、OVID循证医学数据库、中国生物医学文献数据库,并专门检索Ann Rheum Dis及相关灰色文献,按照Cochrane协作网推荐的诊断试验的纳入标准筛选文献,应用MATLAB软件、Review Manager 4．2软件及“调整SROC法”对纳入研究进行综合定量评价。结果共纳入22篇中英文文献,抗-CCP抗体对RA诊断的敏感度范围为39．2％～84．6％,特异度范围为90％～97．9％;纳入研究存在异质性,按照随机效应模型计算汇总加权灵敏度和特异度及95％可信区间分别为77．3％(63．1％,89．2％)和93．85％(85．5％, 98．1％),相应的阳性似然比和阴性似然比为12．0和0．24;拟合SROC曲线下面积为0．8976,Q值为0．87;进一步对病程小于1年和大于1年汇总分析,病程小于1年或病程大于1年研究层定量合并灵敏度和特异度分别为43％、94．2％和70．2％、95．2％,合并进行层间比较灵敏度差异有统计学意义(P<0．001)而特异度差异无统计学意义(P=0．94)。结论抗-CCP抗体诊断RA的灵敏度、特异度均较高,在综合考虑可能影响评价结果的前提下,对临床诊断有指导作用。
Objective To evaluate the clinical diagnostic value of anti-cyclic citrullinated peptide (CCP) antibody in rheumatoid arthritis (RA). METHODS: The Cochrane Library, PubMed Database, EMBASE Database, OVID Evidence-Based Medicine Database and Chinese Biomedical Literature Database were searched from January 2000 to December 2005. Ann Rheum Dis and related gray literature were searched exclusively. According to the recommendations of the Cochrane Collaboration Diagnostic tests included in the standard screening literature, the application of MATLAB software, Review Manager 4.2 software and “adjust the SROC method” for comprehensive quantitative evaluation of the included studies. Results A total of 22 Chinese and English articles were included. The sensitivity of anti-CCP antibody to RA was 39.2% -84.6% and the specificity was 90% -97.9%. The heterogeneity, The pooled weighted sensitivity and specificity and 95% confidence intervals were calculated as 77.3% (63.1%, 89.2%) and 93.85% (85.5%, 98.1%), respectively, according to the random effects model , The corresponding positive likelihood ratios and negative likelihood ratios were 12.0 and 0.24; the area under the fitted SROC curve was 0.8976, the Q value was 0.87; and further the summary of the disease course of less than 1 year and more than 1 year Analysis, the duration of less than 1 year or duration of more than 1 year quantitative analysis of the sensitivity and specificity of the study were 43%, 94.2% and 70.2%, 95.2%, combined with the sensitivity of the difference between the layers was statistically significant (P <0.001) while the specificity was not significantly different (P = 0.94). Conclusion The sensitivity and specificity of anti-CCP antibody in the diagnosis of RA are high, and it has a guiding role in clinical diagnosis on the premise of considering the possible impact on the evaluation results. Objective To evaluate the clinical diagnostic value of anti-cyclic citrullinated peptide (CCP) antibody in rheumatoid arthritis (RA). METHODS: The Cochrane Library, PubMed Database, EMBASE Database, OVID Evidence-Based Medicine Database and Chinese Biomedical Literature Database were searched from January 2000 to December 2005. Ann Rheum Dis and related gray literature were searched exclusively. According to the recommendations of the Cochrane Collaboration Diagnostic tests included in the standard screening literature, the application of MATLAB software, Review Manager 4.2 software and “adjust the SROC method” for comprehensive quantitative evaluation of the included studies. Results A total of 22 Chinese and English articles were included. The sensitivity of anti-CCP antibody to RA was 39.2% -84.6% and the specificity was 90% -97.9%. The heterogeneity, The pooled weighted sensitivity and specificity and 95% confidence intervals were calculated as 77.3% (63.1%, 89.2%) and 93.85% (85.5%, 98.1%), respectively, according to the random effects model , The corresponding positive likelihood ratios and negative likelihood ratios were 12.0 and 0.24; the area under the fitted SROC curve was 0.8976, the Q value was 0.87; and further the summary of the disease course of less than 1 year and more than 1 year Analysis, the duration of less than 1 year or duration of more than 1 year quantitative analysis of the sensitivity and specificity of the study were 43%, 94.2% and 70.2%, 95.2%, combined with the sensitivity of the difference between the layers was statistically significant (P <0.001) while the specificity was not significantly different (P = 0.94). Conclusion The sensitivity and specificity of anti-CCP antibody in the diagnosis of RA are high, and it has a guiding role in clinical diagnosis on the premise of considering the possible impact on the evaluation results.