本文關(guān)鍵詞：γ-干擾素釋放試驗鑒別腸結(jié)核與克羅恩病的臨床價值　出處：《重慶醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的:系統(tǒng)評價兩種不同的γ-干擾素釋放試驗(interferon-γreleasing assay,IGRA)對鑒別腸結(jié)核(intestinal tuberculosis,ITB)和克羅恩病(Crohn’s disease,CD)的診斷價值。方法:計算機(jī)檢索Embase、PubMed、EBM Reviews、相關(guān)期刊論文、萬方數(shù)字化期刊全文數(shù)據(jù)庫,查找評價IGRA在ITB與CD鑒別診斷價值的文獻(xiàn),時間是建庫至2016年1月,對納入的文獻(xiàn)進(jìn)行質(zhì)量評價,采用Meta-Disc 1.4軟件進(jìn)行Meta分析,分別匯總2種IGRA的敏感度、特異度及95%可信性區(qū)間(95%confidence interval,95%CI)。根據(jù)匯總受試者工作特征曲線(summary reciever operating characteristic,SROC),計算曲線下面積(area under curve,AUC),得出各自的Q*值,評價不同方法的診斷價值。結(jié)果:共納入12篇文獻(xiàn),總病例數(shù)854例(ITB 367例,CD 487例)。結(jié)核感染T淋巴細(xì)胞斑點試驗(T SPOT tuberculosis,T-SPOT.TB)的匯總敏感度和特異度分別為0.89(95%CI=0.84~0.93)、0.85(95%CI=0.81~0.89)。結(jié)核桿菌T淋巴細(xì)胞檢測(QuantiFeron tuberculosis,QuantiFeron-TB)的匯總敏感度和特異度分別為0.72(95%CI=0.64~0.79)、0.92(95%CI=0.86~0.96)。兩組的SROC曲線下面積分別為0.9450,0.9110。兩者Q*值分別為0.8839、0.8432,比較兩組Q*值,差異無統(tǒng)計學(xué)意義(P=0.164)。結(jié)論:T-SPOT與QuantiFeron-TB在鑒別ITB與CD上有較高的敏感度、特異度,準(zhǔn)確率高,是鑒別ITB與CD的有效輔助手段,兩者診斷準(zhǔn)確性差異比較無統(tǒng)計學(xué)意義。
[Abstract]:Objective: To evaluate two kinds of interferon gamma release test (interferon- gamma releasing assay, IGRA) in the differential diagnosis of intestinal tuberculosis (intestinal, tuberculosis, ITB) and Crohn's disease (Crohn 's disease, CD) diagnostic value. Methods: We searched Embase, PubMed, EBM, Reviews, Chinese CNKI, Wanfang digital periodical full-text database, search literature evaluation value of IGRA in differential diagnosis of ITB and CD, the time is up to January 2016, to evaluate the quality of the included studies. Meta analysis was performed using Meta-Disc 1.4 software, 2 IGRA summary of sensitivity, specificity and 95% confidence intervals (95%confidence, interval, 95%CI) according to the summary. The receiver operating characteristic curve (summary reciever operating characteristic, SROC), calculate the area under the curve (area under, curve, AUC), the respective Q* values, different methods to evaluate the diagnostic value of Value. Results: a total of 12 articles were included, the total number of cases in 854 cases (ITB 367 cases, CD 487 cases). Tuberculosis infection T lymphocytes (T SPOT spot test tuberculosis, T-SPOT.TB) of the pooled sensitivity and specificity were 0.89 (95%CI=0.84~0.93), 0.85 (95%CI=0.81~0.89). The detection of TB (T lymphocyte QuantiFeron tuberculosis, QuantiFeron-TB) of the pooled sensitivity and specificity were 0.72 (95%CI=0.64~0.79), 0.92 (95%CI=0.86~0.96). SROC curve area in two groups were both 0.9450,0.9110. Q* values were compared between the two groups of 0.8839,0.8432, Q* value, the difference was not statistically significant (P=0.164). Conclusion: T-SPOT and QuantiFeron-TB are higher in the differential ITB and CD on the sensitivity, specificity, accuracy, is an effective auxiliary means of identification of ITB and CD, the diagnostic accuracy of the difference was not statistically significant.

【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R524;R574.62

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 潘景潤;吳興旺;劉斌;劉文冬;胡偉杰;;小腸CT對克羅恩病與腸結(jié)核鑒別診斷價值[J];安徽醫(yī)科大學(xué)學(xué)報;2016年01期

2 胡佳;張鑫;張燕;;診斷性抗結(jié)核治療在鑒別腸道克羅恩病與腸結(jié)核中的意義[J];四川大學(xué)學(xué)報(醫(yī)學(xué)版);2015年02期

3 劉瀏;梁志忠;賈柳萍;黃鶴;鄧綠;王澤偉;倫偉健;;結(jié)核感染T細(xì)胞斑點試驗對鑒別克羅恩病和腸結(jié)核的臨床價值[J];中華實用診斷與治療雜志;2014年06期

4 Wen Chen;Jun-Hua Fan;Wei Luo;Peng Peng;Si-Biao Su;;Effectiveness of interferon-gamma release assays for differentiating intestinal tuberculosis from Crohn's disease:A meta-analysis[J];World Journal of Gastroenterology;2013年44期

5 何衛(wèi);陳瑞海;;腸結(jié)核與克羅恩病的鑒別診斷研究[J];中國醫(yī)藥導(dǎo)報;2013年18期

6 史笑梅;褚燕君;張芳賓;賈百靈;;T細(xì)胞斑點試驗在腸結(jié)核與克羅恩病鑒別診斷中的價值[J];河南醫(yī)學(xué)研究;2013年01期

7 陳瑜君;何瑤;陳白莉;毛仁;晁康;徐萍萍;曾志榮;陳e，

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