【摘要】：目的:基于Meta分析結果,運用綜合受試者工作特征曲線技術(summary receiver operating characteristic,SROC)5種技術方法評價妊娠肝內膽汁淤積癥(intrahepatic cholestasis of pregnancy,ICP)中總膽汁酸(total bile acid,TBA)的診斷價值。方法:檢索中文數(shù)據(jù)庫:中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)、萬方、CNKI;英文數(shù)據(jù)庫:Pub Med,High Wire,Ovid,the Cochrane Library,Google scholar research。文獻搜索的截至日期為2015年5月。對所納入的文獻進行質量評價和數(shù)據(jù)提取后,利用Meta分析所收集的TBA的靈敏度、特異度等數(shù)據(jù)信息,運用雙變量隨機效應模型的SROC 5種方法:ηonξ、ξonη、D on S、RG(Rutter and Gatsonis)、主軸法,應用SAS的MIXED和NLMIXED過程步得到參數(shù),建立5種模型,評價TBA對ICP的診斷價值。結果:通過Meta分析檢索步驟,最終納入6篇文獻,根據(jù)5種方法計算出診斷評價結果曲線下面積(area under curve,AUC)值顯示:ηonξ:0.711,ξonη:0.448;D on S:0.730;RG:0.801;主軸法:0.703,提示TBA的診斷準確性較高,而5種技術方法的AUC和SROC圖形結果顯示:RG評價TBA準確性的效果較其他方法更好。結論:TBA診斷ICP的準確性較好,但RG的效果評價需進一步驗證。
[Abstract]:Aim: to evaluate the diagnostic value of total bile acid (total bile acid,TBA) in intrahepatic cholestasis of pregnancy (intrahepatic cholestasis of pregnancy,ICP) by five techniques based on the results of Meta analysis and comprehensive receiver operating characteristic curve (summary receiver operating characteristic,SROC) technique. Methods: Chinese database: (CBM), Wanfang, CNKI; English database: Pub Med,High Wire,Ovid,the Cochrane Library,Google scholar research. The deadline for literature search is May 2015. After the quality evaluation and data extraction of the included documents, the sensitivity and specificity of the collected TBA were analyzed by Meta, and five methods of SROC of the bivariate random effect model were used: 畏 on 尉, 尉 on 畏, D on S, RG (Rutter and Gatsonis),. Using SAS's MIXED and NLMIXED process steps to get parameters, five models were established to evaluate the diagnostic value of TBA for ICP. Results: by means of Meta analysis and retrieval steps, six literatures were included. According to five methods, the area (area under curve,AUC under the curve of diagnostic evaluation results was calculated. The results showed that 畏 on 尉: 0.711, 尉 on 畏: 0.448 D on S = 0.730; RG:0.801; spindle method: 0.703, which indicated that the diagnostic accuracy of TBA was higher than that of other methods. The results of AUC and SROC showed that RG was more effective than other methods in evaluating the accuracy of TBA. The results of AUC and SROC showed that RG was more effective than other methods in evaluating the accuracy of TBA. Conclusion: the accuracy of TBA in the diagnosis of ICP is good, but the evaluation of the effect of RG should be further verified.
【作者單位】： 重慶醫(yī)科大學公共衛(wèi)生與管理學院衛(wèi)生統(tǒng)計與信息管理教研室;
【基金】：國家自然科學基金資助項目(編號:81373103) 重慶市自然科學基金資助項目(編號:cstc2013jcyj A0068)
【分類號】：R714.25;R-03

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