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目的目前肺隐球菌病的诊断缺乏金标准,本研究旨在评价乳胶凝集试验对肺隐球菌病的诊断价值,为临床提供参考。方法检索中国知网、维普网、万方数据、Pubmed、EMbase、Web of Science、Sumsearch、TRIP、循证医学中心、CATbank、Cochrance组织、Evidence-baseed health、Netting the Evidence、社区预防服务指南、National Guideline Clearinghouse等国内外数据库或搜索引擎,收集探索乳胶凝集试验对肺炎隐球菌感染诊断价值的诊断性研究,筛选、评价文献并提取数据进行Meta分析,计算灵敏度、特异度、阳性似然比、阴性似然比以及诊断优势比等指标。结果本次研究共检索到287篇相关文献,最终共纳入7个文献,其中5篇研究来自中国,2篇来自日本;发表时间从1993—2012年;共计686例研究对象,其中肺隐球菌病152例,非肺隐球菌病534例。采用QUADAS评分标准评价纳入文献的方法学质量,纳入的7篇文献QUADAS评分均≥9分。使用Rev-Man 5.3软件进行数据分析,分析乳胶凝集试验诊断肺隐球菌病的临床价值。7篇文献的灵敏度为60.00%~100.00%,P<0.000 1,各研究的灵敏度之间存在统计学异质性,特异度为85.71%~100.00%,P<0.000 1,各研究的特异度之间存在统计学异质性。Meta分析结果显示,乳胶凝集试验诊断肺隐球菌病的合并灵敏度为0.80[0.72,0.86],合并特异度为0.99[0.98,1.00]。结论 Meta分析结果证明,乳胶凝集试验对肺隐球菌病具有很高的诊断价值。
Objective The present diagnosis of pulmonary cryptococcosis lacks the gold standard. This study aimed to evaluate the diagnostic value of latex agglutination test for pulmonary cryptococcosis and provide a reference for clinical practice. PubMed, EMbase, Web of Science, Sumsearch, TRIP, The Evidence-Based Medicine Center, CATbank, Cochrance, Evidence-based health, Netting the Evidence, Guide to community preventive services, National Guideline Clearinghouse and other domestic and foreign databases or search engines to collect and explore the latex agglutination test diagnostic value of Cryptococcus pneumoniae diagnosis, screening, evaluation of the literature and data extraction Meta analysis to calculate the sensitivity, specificity, positive likelihood ratio, negative Likelihood ratio and diagnostic odds ratio and other indicators. Results A total of 287 related articles were retrieved in this study. In the end, a total of 7 articles were included, of which 5 were from China and 2 were from Japan. The published time ranged from 1993 to 2012. A total of 686 subjects were studied, of which pulmonary cryptococcosis 152 cases, 534 cases of non-pulmonary cryptococcosis. The QUADAS score was used to evaluate the methodological quality of the included articles. All seven articles included QUADAS scores ≥9. The data of Rev-Man 5.3 software was used to analyze the clinical value of latex agglutination test in the diagnosis of pulmonary cryptococcosis. The sensitivity of the seven articles was 60.00% ~ 100.00%, P <0.0001. There was statistical heterogeneity between the sensitivity of each study, the specificity was 85.71% -100.00%, P <0.0001. The specificity of each study There is statistical heterogeneity between. Meta-analysis showed that the combined sensitivity of latex agglutination test for diagnosis of pulmonary cryptococcosis was 0.80 [0.72,0.86] and the specificity of combination was 0.99 [0.98, 1.00]. Conclusion Meta analysis results show that latex agglutination test for pulmonary cryptococcosis has a high diagnostic value.