酶免疫法對沙眼衣原體診斷價值的Meta分析_《中國循證醫學雜志》

作者：

 安妮 ^1,2 , 葛龍 ^1,2 , 徐俊峰 ^1,2 , 石新彤 ^1,2 , 梁莉 ^1,2 , 周為文 ^1,3 , 劉銀春 ^1,2 , 馬繼春 ¹ , 娜和亞 ¹ , 田金徽 ¹

1.蘭州大學基礎醫學院，蘭州大學循證醫學中心（蘭州 730000）；2.蘭州大學第一臨床醫學院（蘭州 730000）；3.蘭州大學第二臨床醫學院（蘭州 730000;

關鍵詞：

酶免疫法沙眼衣原體診斷性試驗 Meta分析

DOI：

10.7507/1672-2531.20130029

視頻：

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目的　系統評價酶免疫法診斷沙眼衣原體的準確性。
方法　計算機檢索PubMed（1966～2011.12）、The Cochrane Library（2011.12）、EMbase（1974～2011.12）、CNKI（1994～2011.12）、VIP（1989～2011.12）和CBM（1978～2011.12），并輔助手工檢索和其他檢索，收集EIA診斷沙眼衣原體的試驗研究。由兩名評價者依據QUADAS質量評價標準評價納入研究的質量后，采用Meta Analyst和RevMan 5.0軟件進行Meta分析。
結果　最終共納入17個研究，9 461例受試者。Meta分析結果顯示：酶免疫法診斷沙眼衣原體的合并敏感度、特異度、陽性似然比、陰性似然比、診斷比值比和SROC曲線下面積分別為0.847［95%CI（0.571，0.995）］、0.964［95%CI（0.890，0.994）］、25.972［95%CI（18.587，36.293）］、0.156［95%CI（0.114，0.212）］、228.875［95%CI（127.136，412.028）］和0.953。
結論　酶免疫法對診斷沙眼衣原體具有較高的敏感度和特異度，推薦酶免疫法用于沙眼衣原體的初篩及確診高度疑似病例或癥狀體征不明顯的患者。

引用本文： 安妮,葛龍,徐俊峰,石新彤,梁莉,周為文,劉銀春,馬繼春,娜和亞,田金徽. 酶免疫法對沙眼衣原體診斷價值的Meta分析. 中國循證醫學雜志, 2013, 13(2): 165-169. doi: 10.7507/1672-2531.20130029 復制

1.	Bassiri M, Hu HY, Domeika MA, et al. Detection of Chlamydia trachomatis in Urine Specimens from Women by Ligase Chain Reaction. J Clin Microbiol, 1995, 33(4): 898-900.
2.	Washington AE, Johnson RE, Sanders LL, et al. Chlamydia trachomatis Infections in the United States. JAMA, 1987, 257: 2070-2072.
3.	Mårdh PA, Møller BR, Paavonen J (ed.). Chlamydia trachomatis in genital and related infections. Almqvist & Wiksell International, Stockholm. Medical chlamydiology—a position paper, 1982: 3-8.
4.	Stamm WE, Clark A. Use of the Abbott LCR assay to identify chlamydia-infected men and women using urine specimens. Sex. Transm. Dis, 1994, 21(Suppl.): 126.
5.	Centers for Disease Control. Chlamydia trachomatis infections, policy guidelines for prevention and control. Morbid. Mortal. Weekly Rep, 1985, 34 Suppl 3: 53S-74S.
6.	Rahm VA, Gnarpe H, Odlind V. Chlamydia trachomatis among sexually active teenage girls. Lack of correlation between chlamydial infection, history of the patient and clinical signs of infection. Br J Obstet Gynaecol, 1988, 95(9): 916-919.
7.	姚兵, 楊岳琴, 朱啟錠. 套式聚合酶鏈反應結合直接熒光法檢測女性生殖道沙眼衣原體. 中華醫學檢驗雜志, 1998, 21: 338-341.
8.	Thejls H, Gnarpe J, Gnarpe H, et al. Expanded gold standard in the diagnosis of Chlamydia trachomatis in a low prevalence population: diagnostic efficacy of tissue culture, direct immunofluorescence, enzyme immunoassay, PCR and serology. Genitourin Med, 1994, 70(5): 300-303.
9.	Markus B, Heiner B, Matthias E, et al. The Bayes Library of Diagnostic Studies and Reviews. 2nd edition. 2002.
10.	Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Metodol, 2003, 3: 2-5.
11.	鄭和平, 李美玲, 黃進梅, 等. MicrotrakⅡ EIA 法檢測泌尿生殖道沙眼衣原體感染. 嶺南皮膚性病科雜志, 2004, 11(3): 207-209.
12.	葉順章, 陶俊, 鐘銘英, 等. 細胞培養法檢測淋病患者泌尿生殖道沙眼衣原體的研究. 中國皮膚性病學雜志, 1995, 9(3): 142-143.
13.	張莉, 宋衛忠, 梁艷華, 等. 細胞培養和酶聯免疫法檢測沙眼衣原體的比較研究. 中國熱帶醫學雜志, 2006, 6(8): 1471-1472.
14.	Warren R, Dwyer B, Plackett M, et al. Comparative Evaluation of Detection Assays for Chlamydia trachomatis. J Clin Microbiol, 1993, 31(6): 1663-1666.
15.	Mumtaz G, Clark S, Ridgway GL, et al. Comparison of an enzyme immuno- assay (Antigenz Chlamydia) with cell culture for thedetection of genital chlamydial infection in high and low risk populations. Genitourin Med, 1993, 69(2): 119-122.
16.	Chomvarin C, Chantarasuk Y, Thongkrajai P, et al. Development of EIA for detection of Chlamydia trachomatis in genital specimens. Southeast Asian J Trop Med Public Health, 2000, 31(1): 96-103.
17.	Mumtaz G, Ridgway GL, Nayagam A, et al. Enzyme immunoassay compared with cell culture and immunofluorescence for detecting genital chlamydia. J Clin Pathol, 1989, 42(6): 658-660.
18.	Ehret JM, Leszcynski JC, Douglas JM, et al. Evaluation of Chlamydiazyme Enzyme Immunoassay for Detection of Chlamydia trachomatis in Urine Specimens from Men. J Clin Microbiol, 1993, 31(10): 2702-2705.
19.	Srivasin V, Lim KB, Thirumoorthy T, et al. Enzyme immunoassay (Chlamydiazyme) for the detection of chlamydial antigen in endocervical specimens. Singapore Med J, 1989, 30(5): 449-450.
20.	Talbot H, Romanowski B. Factors affecting urine EIA sensitivity in the detection of Chlamydia trachomatis in men. Genitourin Med, 1994, 70(2): 101-104.
21.	Tjiam KH, van Heijst BY, van Zuuren A, et al. Evaluation of an enzyme immunoassay for the diagnosis of chlamydial infections in urogenital specimens. J Clin Microbiol, 1986, 23(4): 752-754.
22.	Jones MF, Smith TF, Houglum AJ, et al. Detection of Chlamydia trachomatis in Genital Specimens by the Chlamydiazyme Test. J Clin Microbiol, 1984, 20(3): 465-467.
23.	LeBar W, Herschman B, Jemal C, et al. Comparison of DNA probe, monoclonal antibody enzyme immunoassay, and cell culture for the detection of Chlamydia trachomatis. J Clin Microbiol, 1989, 27(5): 826-828.
24.	Hammerschlag MR, Roblin PM, Cummings C, et al. Comparison of enzyme immunoassay and culture for diagnosis of chlamydial conjunctivitis and respiratory infections in infants. J Clin Microbiol, 1987, 25(12): 2306-2308.
25.	Mahony J, Castriciano S, Sellors J, et al. Diagnosis of Chlamydia trachomatis genital infections by cell culture and two enzyme immunoassays detecting different chlamydial antigens. J Clin Microbiol, 1989, 27(9): 1934-1938.
26.	Clarke LM, Sierra MF, Daidone BJ, et al. Comparison of the Syva MicroTrak enzyme immunoassay and Gen-Probe PACE 2 with cell culture for diagnosis of cervical Chlamydia trachomatis infection in a high-prevalence female population. J Clin Microbiol, 1993, 31(4): 968-971.
27.	El-Sayed M, Badwy W, Bakr A. Rapid Hybridization Probe Assay and PCR for Detection of Chlamydia trachomatis in Urinary Tract Infections: A Prospective Study. Curr Microbiol, 2006, 53(5): 379-383.

1. Bassiri M, Hu HY, Domeika MA, et al. Detection of Chlamydia trachomatis in Urine Specimens from Women by Ligase Chain Reaction. J Clin Microbiol, 1995, 33(4): 898-900.
2. Washington AE, Johnson RE, Sanders LL, et al. Chlamydia trachomatis Infections in the United States. JAMA, 1987, 257: 2070-2072.
3. Mårdh PA, Møller BR, Paavonen J (ed.). Chlamydia trachomatis in genital and related infections. Almqvist & Wiksell International, Stockholm. Medical chlamydiology—a position paper, 1982: 3-8.
4. Stamm WE, Clark A. Use of the Abbott LCR assay to identify chlamydia-infected men and women using urine specimens. Sex. Transm. Dis, 1994, 21(Suppl.): 126.
5. Centers for Disease Control. Chlamydia trachomatis infections, policy guidelines for prevention and control. Morbid. Mortal. Weekly Rep, 1985, 34 Suppl 3: 53S-74S.
6. Rahm VA, Gnarpe H, Odlind V. Chlamydia trachomatis among sexually active teenage girls. Lack of correlation between chlamydial infection, history of the patient and clinical signs of infection. Br J Obstet Gynaecol, 1988, 95(9): 916-919.
7. 姚兵, 楊岳琴, 朱啟錠. 套式聚合酶鏈反應結合直接熒光法檢測女性生殖道沙眼衣原體. 中華醫學檢驗雜志, 1998, 21: 338-341.
8. Thejls H, Gnarpe J, Gnarpe H, et al. Expanded gold standard in the diagnosis of Chlamydia trachomatis in a low prevalence population: diagnostic efficacy of tissue culture, direct immunofluorescence, enzyme immunoassay, PCR and serology. Genitourin Med, 1994, 70(5): 300-303.
9. Markus B, Heiner B, Matthias E, et al. The Bayes Library of Diagnostic Studies and Reviews. 2nd edition. 2002.
10. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Metodol, 2003, 3: 2-5.
11. 鄭和平, 李美玲, 黃進梅, 等. MicrotrakⅡ EIA 法檢測泌尿生殖道沙眼衣原體感染. 嶺南皮膚性病科雜志, 2004, 11(3): 207-209.
12. 葉順章, 陶俊, 鐘銘英, 等. 細胞培養法檢測淋病患者泌尿生殖道沙眼衣原體的研究. 中國皮膚性病學雜志, 1995, 9(3): 142-143.
13. 張莉, 宋衛忠, 梁艷華, 等. 細胞培養和酶聯免疫法檢測沙眼衣原體的比較研究. 中國熱帶醫學雜志, 2006, 6(8): 1471-1472.
14. Warren R, Dwyer B, Plackett M, et al. Comparative Evaluation of Detection Assays for Chlamydia trachomatis. J Clin Microbiol, 1993, 31(6): 1663-1666.
15. Mumtaz G, Clark S, Ridgway GL, et al. Comparison of an enzyme immuno- assay (Antigenz Chlamydia) with cell culture for thedetection of genital chlamydial infection in high and low risk populations. Genitourin Med, 1993, 69(2): 119-122.
16. Chomvarin C, Chantarasuk Y, Thongkrajai P, et al. Development of EIA for detection of Chlamydia trachomatis in genital specimens. Southeast Asian J Trop Med Public Health, 2000, 31(1): 96-103.
17. Mumtaz G, Ridgway GL, Nayagam A, et al. Enzyme immunoassay compared with cell culture and immunofluorescence for detecting genital chlamydia. J Clin Pathol, 1989, 42(6): 658-660.
18. Ehret JM, Leszcynski JC, Douglas JM, et al. Evaluation of Chlamydiazyme Enzyme Immunoassay for Detection of Chlamydia trachomatis in Urine Specimens from Men. J Clin Microbiol, 1993, 31(10): 2702-2705.
19. Srivasin V, Lim KB, Thirumoorthy T, et al. Enzyme immunoassay (Chlamydiazyme) for the detection of chlamydial antigen in endocervical specimens. Singapore Med J, 1989, 30(5): 449-450.
20. Talbot H, Romanowski B. Factors affecting urine EIA sensitivity in the detection of Chlamydia trachomatis in men. Genitourin Med, 1994, 70(2): 101-104.
21. Tjiam KH, van Heijst BY, van Zuuren A, et al. Evaluation of an enzyme immunoassay for the diagnosis of chlamydial infections in urogenital specimens. J Clin Microbiol, 1986, 23(4): 752-754.
22. Jones MF, Smith TF, Houglum AJ, et al. Detection of Chlamydia trachomatis in Genital Specimens by the Chlamydiazyme Test. J Clin Microbiol, 1984, 20(3): 465-467.
23. LeBar W, Herschman B, Jemal C, et al. Comparison of DNA probe, monoclonal antibody enzyme immunoassay, and cell culture for the detection of Chlamydia trachomatis. J Clin Microbiol, 1989, 27(5): 826-828.
24. Hammerschlag MR, Roblin PM, Cummings C, et al. Comparison of enzyme immunoassay and culture for diagnosis of chlamydial conjunctivitis and respiratory infections in infants. J Clin Microbiol, 1987, 25(12): 2306-2308.
25. Mahony J, Castriciano S, Sellors J, et al. Diagnosis of Chlamydia trachomatis genital infections by cell culture and two enzyme immunoassays detecting different chlamydial antigens. J Clin Microbiol, 1989, 27(9): 1934-1938.
26. Clarke LM, Sierra MF, Daidone BJ, et al. Comparison of the Syva MicroTrak enzyme immunoassay and Gen-Probe PACE 2 with cell culture for diagnosis of cervical Chlamydia trachomatis infection in a high-prevalence female population. J Clin Microbiol, 1993, 31(4): 968-971.
27. El-Sayed M, Badwy W, Bakr A. Rapid Hybridization Probe Assay and PCR for Detection of Chlamydia trachomatis in Urinary Tract Infections: A Prospective Study. Curr Microbiol, 2006, 53(5): 379-383.

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酶免疫法對沙眼衣原體診斷價值的Meta分析

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《中國循證醫學雜志》

酶免疫法對沙眼衣原體診斷價值的Meta分析

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