中国实用内科杂志2011，Vol.31Issue(5)：358-361,4.
腺苷脱氨酶诊断结核性脑膜炎价值Meta分析
Diagnostic value of adenosine deaminase in tuberculous meningitis:a meta-analysis
张峰 1孙文逵 2李子玲 2施毅2
作者信息
- 1. 连云港市第一人民医院呼吸内科,江苏,连云港,222002
- 2. 南京军区南京总医院呼吸内科,南京,210002
- 折叠
摘要
Abstract
Objective To investigate the effect of Adenosine deaminase (ADA) from Cerebrospinal fluid (CSF) in early diagnosis of tuberculous meningitis via a meta-analysis. Methods Between January 1995 and December 2009, Medline, EMbase, BIOSIS and Cochrane databases were searched for relevant English articles on detection of ADA from CSF in diagnosis of tuberculous meningitis. Quality evaluation of these studies was performed using QUADAS standards. The random effect model of Metadisc 1.4 and SPSS 13.0 softwares was used for pooled analysis of the sensitivity, specificity and other indexes of ADA in diagnosis of tuberculous meningitis in all studies. The receiver operating characteristic curves were then generated and studied for its use in diagnosis. Results Nine studies were finally included in this meta-analysis. The overall sensitivity of ADA in diagnosis of tuberculous meningitis was 0. 77 (95％ CI0. 72 ～ 0. 82 ), specificity 0. 91 (95％ CI 0. 90 ～ 0. 93 ), positive likelihood ratio 7. 93 (5. 85 ～ 10. 76) ,negative likelihood ratio 0. 28(0. 19 ～0. 41 ) and area under curve (AUC) of SROC 0. 9129.However,the specificity of differential diagnosis between tuberculous and purulent meningitis was decreased to 0. 75 (95％ CI 0. 67 ～ 0. 82). Conclusion Both seasifivity and specificity of ADA were favorably high in diagnosis of tuberculous meningitis. The detection of ADA in CSF might contribute to diagnosis of tuberculous meningitis;however,this could lead to lowered efficiency in differential diagnosis against purulent meningitis,hence a need for references to other laboratory indexes.关键词
Meta分析/结核性脑膜炎/腺苷脱氨酶/脑脊液分类
医药卫生引用本文复制引用
张峰,孙文逵,李子玲,施毅..腺苷脱氨酶诊断结核性脑膜炎价值Meta分析[J].中国实用内科杂志,2011,31(5):358-361,4.
