摘要
目的 采用诊断试验Meta分析方法综合评价抗环瓜氨酸肽抗体（抗CCP）和类风湿因子（RF）筛查类风湿性关节炎（RA）的效果,得到各种筛查方法的综合灵敏度.方法 通过检索万方、维普、CNKI等数据库,获得同时有抗CCP和RA诊断筛查RA的文献23篇,直接或间接提取真阳性数（TP）、假阳性数（NP）、假阴性数（FN）、真阴性数数据（TN）;采用DPS 6.5进行诊断试验Meta分析,采用加权法、非加权法以及稳健法三种方法分别拟合两种筛查方法的受试者工作特征曲线（SROC曲线）,比较两种筛查方法诊断RA效果的差别.结果 稳健法结果较为稳定,其结果显示抗CCP筛查RA的综合准确度为0.831,诊断优势比为24.154;RF的综合准确度为0.765,诊断优势比为10.540;抗CCP筛查RA的诊断准确度明显高于RF（P〈0.01）.结论 抗CCP筛查诊断RA能获得较好的准确度,明显高于RF筛查诊断RA所获得的准确度;文献结果显示抗CCP能获得较好的特异度,而RF能获得较好的灵敏度,若能联合抗CCP和RF筛查结果,对RA具有较高的诊断价值.
Objective To evaluate comprehensively the diagnostic test effect of anti-CCP and RF to screen RA with the use of Meta analysis of diagnostic test, and to obtain comprehensive sensitivity in different screening methods. Methods We searched Wanfang, Weipu, and CNKI databases to get 23 native language studies in which RA was screened by anti-CCP and RF, and then extracted TP, NP., FN and TN. With the use of DPS Software Version 6.5, Meta analysis was undertaken with weighting method, non-weighting mehtod and robust method to draw up summary receiver operating characteristic curve （SROC） in the two screening methods. Results Robust method of Meta analysis indicated that the TPR ＊ of anti-CCP was 0. 831 and di- agnostic OR was 24. 154. RF screening method was O. 765 and 10. 540 respectively. The accuracy of anti-CCP was much higher than RF（ P〈O. 01 ）. Conclusion We can get a better diagnostic accuracy from anti-CCP screening RA than RF screening RA. The result of literature showed that there was a better specificity in anti-CCP Screening RA and a better sensitivity in RF screening RA. If we combine the two screening methods, we can get a better diagnostic value of RA.
出处
《中国医院统计》
2012年第2期97-101,共5页
Chinese Journal of Hospital Statistics
关键词
类风湿性关节炎
抗环瓜氨酸肽抗体
类风湿因子
META分析
Rheumatoid arthritis （RA） Anti-cyclic citrullinated peptide antibody （Anti-CCP） Rheumatoid factor （RF） Meta mialysis
