基于支气管肺泡灌洗液的专家MTB/RIF检测诊断肺结核:系统回顾和荟萃分析

IF 2 Q3 INFECTIOUS DISEASES
Hao Chen, Chun-Xi Lin, Peng-Li Lv, Wen-feng Li, Yu-Ying Feng, X. Deng, Jianhan Xiao, Xu-guang Guo
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引用次数: 0

摘要

摘要目前,结核病是由单一传染性病原体引起的世界第二大致死性疾病。结核病的快速诊断对结核病的治疗和管理具有重要意义。Xpert MTB/RIF是一种新型的肺结核快速诊断方法。当怀疑结核病且痰涂片或培养物呈阴性时,应使用基于支气管肺泡灌洗液(BALF)样本的Xpert测定法。本荟萃分析的目的是系统评估基于BALF样本的Xpert测定对PTB的诊断性能。对先前发表的文章进行了系统综述,并提取了相关数据。Meta-DiSc 1.4和Stata 12.0用于分析数据。当以结核分枝杆菌培养物为标准时,基于BALF的Xpert的联合敏感性为0.89(95%CI,0.87–0.91),特异性为0.87(95%CI),0.85-0.88),阳性似然比为8.28(95%CI,5.39–12.71),负似然比为0.14(95%CI,0.10–0.19),诊断比为84.08(95%CI:42.00–168.31)。当使用复合参考标准作为标准时,上述观察结果分别为0.69(95%CI为0.67–0.72)、0.98(95%CI是0.97–0.98)、41.40(95%CI值为14.56–117.71)、0.28(95%CI值为0.21–0.37)和190.47(95%CI数值为50.56–717.54)。对于这两种情况,总结接收器工作特性曲线下的面积都接近1。总体而言,基于BALF样本的Xpert MTB/RIF检测对PTB的诊断显示出高灵敏度和特异性,似乎是一种可靠的快速检测方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Xpert MTB/RIF Assay for the Diagnosis of Pulmonary Tuberculosis Based on Bronchoalveolar Lavage Fluid: A Systematic Review and Meta-analysis
Abstract Currently, tuberculosis (TB) is the second most lethal disease in the world caused by a single infectious pathogen. Rapid diagnosis of TB is of great importance for its treatment and management. Xpert MTB/RIF is a novel rapid diagnostic assay for the diagnosis of pulmonary TB (PTB). Use of the Xpert assay based on bronchoalveolar lavage fluid (BALF) samples is indicated when TB is suspected and sputum smears or cultures are negative. The aim of this meta-analysis was to systematically evaluate the diagnostic performance of the Xpert assay based on BALF samples for the diagnosis of PTB. A systematic review of previously published articles was performed, and relevant data were extracted. Meta-DiSc 1.4 and Stata 12.0 were used to analyze the data. When Mycobacterium tuberculosis cultures were used as the criterion standard, the combined sensitivity of BALF-based Xpert was 0.89 (95% CI, 0.87–0.91), the specificity was 0.87 (95% CI, 0.85-0.88), the positive likelihood ratio was 8.28 (95% CI, 5.39–12.71), the negative likelihood ratio was 0.14 (95% CI, 0.10–0.19) and the diagnostic ratio was 84.08 (95% CI, 42.00–168.31). When composite reference standard was used as the criterion standard, the above observations were 0.69 (95% CI, 0.67–0.72), 0.98 (95% CI, 0.97–0.98), 41.40 (95% CI, 14.56–117.71), 0.28 (95% CI, 0.21–0.37) and 190.47 (95% CI, 50.56–717.54), respectively. The area under the summary receiver operating characteristic curve was close to 1 for both. Overall, the Xpert MTB/RIF assay based on BALF samples showed high sensitivity and specificity for the diagnosis of PTB and seems to be a reliable rapid detection method.
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