Em18抗原ELISA法对泡球蚴病诊断价值的系统评价

目的评价Em18抗原ELISA法对泡球蚴病的诊断价值：方法计算机检索MEDLINE、EMbase、PubMed、TheCochraneLibrary等数据库．手T检索相关期刊，全面收集Em18抗原ELISA法诊断泡球蚴病的相父研究文献，按照QUADAS标准评价纳入文献的质量，采用RevMan4．2．10进行异质性分析和Meta分析，并用Meta-disc软件绘制SROC曲线：结果最终纳入8篇文献，包括409例经金标准确认的泡球蚴病患者、1105例非泡球蚴病患者和216例正常人：Meta分析结果显示：3个使用纯化Em18抗原的研究间未见统计学异质性（P=0．17．F=44．5％），合并的灵敏度、特异度、阳性似然比、阴性似然比及SROC曲线下面积分别为91．5％、91．7％、11．889、0．096和0．9666；4个使用人工重组Em18抗原的研究间未见统计学异质性（P=0．39，F=0．4％），合并的灵敏度、特异度、阳性似然比、阴性似然比及SROC曲线下面积分别为92．2％、95．7％、22．807、0．094和0．9789；使用Em18粗抗原、人工重组Em18—1抗原、人工重组Em18—2抗原的研究各一项，均显示出较好的灵敏度和特异度；1个使用人工重组Em18—3抗原的研究显示特异度较高（99．4％），而灵敏度较低（10．7％）。结论本系统评价显示，用纯化天然Em18抗原ELISA法和人工重组Em18抗原ELISA法检测泡球蚴病具有较大临床应用价值=

Diagnostic Value of Em 18 by Enzyme-linked Immunosorbent Assay (ELISA) in Alveolaris Echinococcosis: A Systematic Review

Objective To evaluate the diagnostic value of Em18 by enzyme-linked immunosorbent assay (ELISA) in the patients with alveolaris echinococcosis (AE). Methods We searched MEDLINE, EMBase, PubMed, The Cochrane Library, and other databases to collect the studies which evaluated the diagnostic value of Em18 in the patients with AE. QUADAS items were used to evaluate the quality of the included studies. The heterogeneity of the included studies and meta-analyses was analyzed by ruing Rev Man 4.2.10. The Summary Recevier Operating Characteristic (SROC) curve was performed by meta-disc. Results Eight studies involving 409 patients with AE diagnosed by the gold standard, 1105 patients with other diseases, and 216 healthy people were included. Meta analyses showed that the pooled sensitivity and pooled specificity of purified Era18 in ELISA were 91.5% and 91.7%, and those of recombinant Em18 were 92.2% and 95.7%, respectively. The AUC of SROC of purified Em18 and recombinant Era18 were 0.966 6 and 0.978 9, respectively. Conclusion Purified Em18 and recombinant Em18 have high value in diagnosis of AE by ELISA.