尿液中AD7c-NTP水平診斷阿爾茨海默病準(zhǔn)確性的系統(tǒng)評價
發(fā)布時間：2019-03-17 07:52
【摘要】：目的評價尿液中阿爾茨海默相關(guān)神經(jīng)絲蛋白(Alzheimer-associated neuronal thread protein, AD7c-NTP)水平診斷阿爾茨海默病(Alzheimer's disease, AD)的價值,以期為臨床決策提供依據(jù)。 方法計算機(jī)檢索Medline、EMbase、Cochrane圖書館、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫、中國知網(wǎng)、萬方和維普等數(shù)據(jù)庫,所有檢索均截止至2013年3月,收集關(guān)于尿液中AD7c-NTP與AD臨床診斷標(biāo)準(zhǔn)比較診斷阿爾茨海默病價值的診斷性試驗,對納入研究進(jìn)行資料提取并應(yīng)用QUADAS條目進(jìn)行方法學(xué)質(zhì)量評估后,使用Stata/SE12.0軟件進(jìn)行Meta分析,采用雙變量混合效應(yīng)模型計算合并靈敏度和特異度、合并似然比和診斷優(yōu)勢比,評價和探索異質(zhì)性、發(fā)表偏倚,并繪制匯總受試者工作特征曲線(Summary receiver operating characteristic curve, SROC curve)和計算曲線下面積(area under the SROC curve, AUC),以評價尿AD7c-NTP診斷AD的價值。 結(jié)果共納入9篇文獻(xiàn),其中經(jīng)臨床診斷標(biāo)準(zhǔn)確認(rèn)的很可能／可能AD患者841例,非AD患者992例。異質(zhì)性檢驗結(jié)果顯示各納入研究結(jié)果間存在統(tǒng)計學(xué)異質(zhì)性,采用雙變量混合效應(yīng)模型進(jìn)行Meta分析,結(jié)果顯示尿液中AD7c-NTP診斷很可能/可能AD的合并靈敏度為0.87(95%CI,0.80-0.91),特異度為0.89(95%CI,0.87-0.91),陽性似然比8.13(95%CI,6.60-10.02),陰性似然比0.15(95%CI,0.10-0.22),SROC曲線下面積(AUC)為0.90(0.87-0.93)。對于很可能AD的病例,合并靈敏度為0.89(95%CI,0.86-0.92),合并特異度為0.90(95%CI,0.88-0.92),合并PLR和NLR分別為8.88(95%CI,7.09-11.12)和0.12(95%CI,0.09-0.16),SROC曲線下面積(AUC)為0.95(95%CI,0.92-0.96)。 結(jié)論尿液中AD7c-NTP是一種比較好的診斷很可能AD的無創(chuàng)性檢查方法,有較高的靈敏度和特異度,但AD7c-NTP能否作為一種早期的生物標(biāo)志物仍需進(jìn)一步研究。
[Abstract]:Objective to evaluate the value of urinary Alzheimer's associated neurofilament (Alzheimer-associated neuronal thread protein, AD7c-NTP) levels in the diagnosis of Alzheimer's disease (Alzheimer's disease, AD) in order to provide evidence for clinical decision-making. Methods the Medline,EMbase,Cochrane Library, Chinese Biomedical Literature Database, China knowledge Network, Wanfang and Vip databases were searched by computer, all of which were up to March 2013. A diagnostic test was collected to compare the clinical diagnostic criteria of AD7c-NTP and AD in urine for the diagnosis of Alzheimer's disease, and after data extraction from the inclusion study and methodological quality assessment using the QUADAS entry, Stata/SE12.0 software was used for Meta analysis. The combined sensitivity and specificity, likelihood ratio and diagnostic advantage ratio were calculated by bivariate mixed effect model, and heterogeneity and publication bias were evaluated and explored. The receiver operating characteristic curve (Summary receiver operating characteristic curve, SROC curve) and the area under the curve (area under the SROC curve, AUC),) were drawn to evaluate the diagnostic value of urinary AD7c-NTP in the diagnosis of AD. Results A total of 9 articles were included, of which 841 patients with AD and 992 patients with non-AD were confirmed by clinical diagnostic criteria. The results of heterogeneity test showed that there was statistical heterogeneity among the study results. The bivariate mixed effect model was used for Meta analysis. The results showed that the combined sensitivity of AD7c-NTP diagnosis in urine was 0.87 (95% CI, 95% CI). 0.80 渭 0.91), specificity 0.89 (95% CI, 0.87 渭 0.91), positive likelihood ratio 8.13 (95% CI, 6.60 渭 10.02), negative likelihood ratio 0.15 (95% CI, 0.10 脳 0.22), positive likelihood ratio 8.13 (95% CI, 6.60 渭 10.02), negative likelihood ratio 0.15 (95% CI, 0.10 渭 0.22). The area under SROC curve was 0.90 (0.87 渭 0.93). For the most likely cases of AD, the combined sensitivity was 0.89 (95% CI, 0.86 渭 0.92), the combined specificity was 0.90 (95% CI, 0.88 渭 0.92), and the combined PLR and NLR were 8.88 (95% CI, 95% CI), respectively. The area (AUC) under curves 7.09 / 11.12) and 0.12 (95% CI, 0.09 / 0.16), SROC) was 0.95 (95% CI, 0.92 渭 0.96). Conclusion AD7c-NTP in urine is a good non-invasive method for the diagnosis of AD with high sensitivity and specificity, but whether AD7c-NTP can be used as an early biomarker should be further studied.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R749.16;R446.12
本文編號：2442082
[Abstract]:Objective to evaluate the value of urinary Alzheimer's associated neurofilament (Alzheimer-associated neuronal thread protein, AD7c-NTP) levels in the diagnosis of Alzheimer's disease (Alzheimer's disease, AD) in order to provide evidence for clinical decision-making. Methods the Medline,EMbase,Cochrane Library, Chinese Biomedical Literature Database, China knowledge Network, Wanfang and Vip databases were searched by computer, all of which were up to March 2013. A diagnostic test was collected to compare the clinical diagnostic criteria of AD7c-NTP and AD in urine for the diagnosis of Alzheimer's disease, and after data extraction from the inclusion study and methodological quality assessment using the QUADAS entry, Stata/SE12.0 software was used for Meta analysis. The combined sensitivity and specificity, likelihood ratio and diagnostic advantage ratio were calculated by bivariate mixed effect model, and heterogeneity and publication bias were evaluated and explored. The receiver operating characteristic curve (Summary receiver operating characteristic curve, SROC curve) and the area under the curve (area under the SROC curve, AUC),) were drawn to evaluate the diagnostic value of urinary AD7c-NTP in the diagnosis of AD. Results A total of 9 articles were included, of which 841 patients with AD and 992 patients with non-AD were confirmed by clinical diagnostic criteria. The results of heterogeneity test showed that there was statistical heterogeneity among the study results. The bivariate mixed effect model was used for Meta analysis. The results showed that the combined sensitivity of AD7c-NTP diagnosis in urine was 0.87 (95% CI, 95% CI). 0.80 渭 0.91), specificity 0.89 (95% CI, 0.87 渭 0.91), positive likelihood ratio 8.13 (95% CI, 6.60 渭 10.02), negative likelihood ratio 0.15 (95% CI, 0.10 脳 0.22), positive likelihood ratio 8.13 (95% CI, 6.60 渭 10.02), negative likelihood ratio 0.15 (95% CI, 0.10 渭 0.22). The area under SROC curve was 0.90 (0.87 渭 0.93). For the most likely cases of AD, the combined sensitivity was 0.89 (95% CI, 0.86 渭 0.92), the combined specificity was 0.90 (95% CI, 0.88 渭 0.92), and the combined PLR and NLR were 8.88 (95% CI, 95% CI), respectively. The area (AUC) under curves 7.09 / 11.12) and 0.12 (95% CI, 0.09 / 0.16), SROC) was 0.95 (95% CI, 0.92 渭 0.96). Conclusion AD7c-NTP in urine is a good non-invasive method for the diagnosis of AD with high sensitivity and specificity, but whether AD7c-NTP can be used as an early biomarker should be further studied.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R749.16;R446.12
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