酶免疫法对沙眼衣原体诊断价值的Meta分析

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）、TheCochraneLibrary（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MetaAnalyst和RevMan5．0软件进行Meta分析。结果最终共纳入17个研究，9461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O．84795％CI（O．571，O．995）]、0．96495％CI（0．890，0．994）j、25．972195％CI（18．587，36．293）j、0．15695％CI（0．114，0．212）j、228．87595％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。

Diagnostic Value of Enzyme Immunoassay for Chlamydia Trachomatis:A Meta-Analysis

Objective To evaluate the diagnostic accuracy of enzyme immunoassay （EIA） for chlamydia trachoma- tis （CT）. Methods The diagnosis trials on EIA for CT were searched in the databases such as PubMed （1966 to Dec. 2011）, The Cochrane Library （Issue 12, 2011）, EMbase （1974 to Dec. 2011）, CNKI （1994 to Dec. 2011）, VIP （1989 to Dec. 2011） and CBM （1978 to Dec. 2011）, meanwhile the manual and other retrieves were also conducted. Two reviewers evaluated the quality of the included trials according to the quality assessment of diagnostic accuracy studies （QUADAS）, and then meta-analysis was performed using Meta Analyst and RevMan 5.0 software. Results A total of 17 trials involv- ing 9 461 participants were included. The results of meta-analysis showed that the weighted sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the area under SROC curve were 0.847 （95%CI 0.571 to 0.995）, 0.964 （95%CI 0.890 to 0.994）, 25.972 （95%CI 18.587 to 36.293）, 0.156 （95%CI 0.114 to 0.212）, 228.875 （95%CI 127.136 to 412.028）, and 0.953, respectively. Conclusion EIA for CT has higher sensitivity and specificity, so EIA is rec- ommended for preliminary screening CT and diagnosing the highly suspected cases or the patients without obvious signs and symptoms.