酶免疫法对沙眼衣原体诊断价值的Meta分析_《中国循证医学杂志》

作者：

 安妮 ^1,2 , 葛龙 ^1,2 , 徐俊峰 ^1,2 , 石新彤 ^1,2 , 梁莉 ^1,2 , 周为文 ^1,3 , 刘银春 ^1,2 , 马继春 ¹ , 娜和亚 ¹ , 田金徽 ¹

1.兰州大学基础医学院，兰州大学循证医学中心（兰州 730000）；2.兰州大学第一临床医学院（兰州 730000）；3.兰州大学第二临床医学院（兰州 730000;

关键词：

酶免疫法沙眼衣原体诊断性试验 Meta分析

DOI：

10.7507/1672-2531.20130029

视频：

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目的　系统评价酶免疫法诊断沙眼衣原体的准确性。
方法　计算机检索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），并辅助手工检索和其他检索，收集EIA诊断沙眼衣原体的试验研究。由两名评价者依据QUADAS质量评价标准评价纳入研究的质量后，采用Meta Analyst和RevMan 5.0软件进行Meta分析。
结果　最终共纳入17个研究，9 461例受试者。Meta分析结果显示：酶免疫法诊断沙眼衣原体的合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比和SROC曲线下面积分别为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。
结论　酶免疫法对诊断沙眼衣原体具有较高的敏感度和特异度，推荐酶免疫法用于沙眼衣原体的初筛及确诊高度疑似病例或症状体征不明显的患者。

引用本文： 安妮,葛龙,徐俊峰,石新彤,梁莉,周为文,刘银春,马继春,娜和亚,田金徽. 酶免疫法对沙眼衣原体诊断价值的Meta分析. 中国循证医学杂志, 2013, 13(2): 165-169. doi: 10.7507/1672-2531.20130029 复制

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, 杨岳琴, 朱启锭. 套式聚合酶链反应结合直接荧光法检测女性生殖道沙眼衣原体. 中华医学检验杂志, 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.	郑和平, 李美玲, 黄进梅, 等. MicrotrakⅡ EIA 法检测泌尿生殖道沙眼衣原体感染. 岭南皮肤性病科杂志, 2004, 11(3): 207-209.
12.	叶顺章, 陶俊, 钟铭英, 等. 细胞培养法检测淋病患者泌尿生殖道沙眼衣原体的研究. 中国皮肤性病学杂志, 1995, 9(3): 142-143.
13.	张莉, 宋卫忠, 梁艳华, 等. 细胞培养和酶联免疫法检测沙眼衣原体的比较研究. 中国热带医学杂志, 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, 杨岳琴, 朱启锭. 套式聚合酶链反应结合直接荧光法检测女性生殖道沙眼衣原体. 中华医学检验杂志, 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. 郑和平, 李美玲, 黄进梅, 等. MicrotrakⅡ EIA 法检测泌尿生殖道沙眼衣原体感染. 岭南皮肤性病科杂志, 2004, 11(3): 207-209.
12. 叶顺章, 陶俊, 钟铭英, 等. 细胞培养法检测淋病患者泌尿生殖道沙眼衣原体的研究. 中国皮肤性病学杂志, 1995, 9(3): 142-143.
13. 张莉, 宋卫忠, 梁艳华, 等. 细胞培养和酶联免疫法检测沙眼衣原体的比较研究. 中国热带医学杂志, 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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酶免疫法对沙眼衣原体诊断价值的Meta分析

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《中国循证医学杂志》

酶免疫法对沙眼衣原体诊断价值的Meta分析

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