發(fā)布時間：2018-06-06 07:22

  本文選題：抗線粒體抗體 + 抗線粒體抗體M2亞型　； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：背景：原發(fā)性膽汁性肝硬化（primary biliary cirrhosis, PBC）是一種自身免疫性疾病，病因尚不清楚，其發(fā)病率呈上升趨勢。PBC患者的診斷對其預(yù)后至關(guān)重要。而抗線粒體抗體（anti-mitochondrial antibody,AMA）陽性被美國肝病研究學(xué)會(AASLD)列為PBC的診斷標(biāo)準(zhǔn)之一。 目的：系統(tǒng)評價AMA及其M2亞型對PBC的診斷價值。 方法：建立檢索策略，搜索PubMed (Medline)、Cochrane圖書館、中國知網(wǎng)和維普中文科技期刊數(shù)據(jù)庫，收集所有與AMA及其M2亞型對PBC診斷相關(guān)的研究文獻(xiàn)與資料。根據(jù)納入和排除標(biāo)準(zhǔn)篩選原始研究文獻(xiàn)，并用QUADAS質(zhì)量評價量表對納入文獻(xiàn)進(jìn)行嚴(yán)格評估；收集、提取、總結(jié)必要的數(shù)據(jù)信息，使用Review Manger5.2和MetaDiSc1.4軟件對納入文獻(xiàn)進(jìn)行匯總與統(tǒng)計描述；根據(jù)異質(zhì)性檢驗結(jié)果選擇合適的合并效應(yīng)量估計模型與方法，進(jìn)行統(tǒng)計推斷。敏感性分析評估Meta分析結(jié)果的真實性與穩(wěn)健性。 結(jié)果：納入文獻(xiàn)24篇：包括19篇英文文獻(xiàn)，5篇中文文獻(xiàn)；病例組樣本量為2992例。異質(zhì)性檢驗結(jié)果提示存在異質(zhì)性（非閾值效應(yīng)），，故采用隨機(jī)效應(yīng)模型合并統(tǒng)計量。Meta分析結(jié)果顯示：不同方法檢測AMA的匯總靈敏度為84.5%(95%CI,83.3% 85.6%)，匯總特異度為97.8%(95%CI,97.6% 98.0%)，匯總陽性似然比為25.201(95%CI,17.583 36.118)，匯總陰性似然比為0.162(95%CI,0.131 0.199)。 結(jié)論：AMA和AMA-M2亞型對PBC的診斷具有較高診斷價值，但相對于AMA-M2亞型來說，AMA具有更全面更高的診斷效能。
[Abstract]:Background: primary biliary cirrhosis, PBC) is an autoimmune disease with primary biliary cirrhosis. The anti-mitochondrial antibody anti-body AMA positive was identified as one of the diagnostic criteria for PBC by the American Society for the study of liver Disease (ASLD). Objective: to evaluate the diagnostic value of AMA and M 2 subtype in PBC. Methods: a search strategy was established to search the PubMed Medline and Cochrane Library, the Chinese Journal of Science and Technology database, and to collect all the literature and data related to the diagnosis of PBC by AMA and its M2 subtype. According to the criteria of inclusion and exclusion, the original research documents were screened, and the QUADAS quality evaluation scale was used to evaluate strictly the included documents, to collect, extract and summarize the necessary data information. The Review Manger5.2 and MetaDiSc1.4 software are used to summarize and describe the literature, and according to the results of heterogeneity test, appropriate models and methods for estimating the combined effect quantity are selected, and the statistical inference is carried out. Sensitivity analysis was used to evaluate the authenticity and robustness of Meta results. Results: 24 articles were included, including 19 English articles and 5 Chinese literatures, the sample size of the case group was 2992 cases. The results of heterogeneity test indicated heterogeneity (non-threshold effect), so the random effect model was used to combine statistics. Meta-analysis results showed that the aggregate sensitivity of different methods for detecting AMA was 83.3% and 85.3%, and the aggregation specificity was 97.895% CII 97.6% and 98.0% respectively. The sex likelihood ratio is 25.201 ~ 95% and the sum negative likelihood ratio is 0.162 ~ 95% ~ 0.131 ~ 0.199. ConclusionAMA and AMA-M2 subtypes have higher diagnostic value for PBC, but they are more effective than AMA-M2 subtypes.
【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】：2014
【分類號】：R575.2

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本文編號：1985745