結核分枝桿菌耐乙胺丁醇診斷試驗的系統評價_《中國循證醫學雜志》

作者：

張志明 ¹ ,  張宗久 ² , 李培杰 ³ , 楊克虎 ² , 祝秉東 ⁴

1. 甘肅省中醫學院附屬醫院（蘭州 730000）；2. 蘭州大學循證醫學中心，蘭州大學基礎醫學院（蘭州 730000）；3. 蘭州大學第二醫院（蘭州 730000）；4. 蘭州大學結核病研究中心（蘭州 730000）;

關鍵詞：

結核分枝桿菌乙胺丁醇診斷試驗系統評價 Meta分析

DOI：

10.7507/1672-2531.20100612

視頻：

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目的　系統評價各種檢測結核分枝桿菌耐乙胺丁醇診斷試驗方法的準確性。
方法　計算機檢索PubMed、EMbase等數據庫，并手工檢索相關期刊，全面收集結核分枝桿菌耐乙胺丁醇診斷試驗的研究，依據QUADAS評價納入診斷試驗的質量，并對結果進行Meta分析。
結果　最終納入9個研究。Meta分析結果顯示：硝酸鹽還原法與比例法相比，以及BACTEC MGIT 960與BACTEC 460 TB相比，其敏感度、特異度、陽性似然比、陰性似然比及SROC曲線下面積分別為92%、99%、30.50、0.13、0.9752和93%、92%、6.27、0.11、0.9；MB/BacT，噬菌體生物擴增法亦顯示了較好的檢驗效能。
結論　硝酸鹽還原試驗可代替比例法作為結核分枝桿菌耐乙胺丁醇的篩查試驗；BACTEC MGIT 960可代替BACTEC 460檢測系統作為結核分枝桿菌耐乙胺丁醇的確診試驗。

引用本文： 張志明,張宗久,李培杰,楊克虎,祝秉東. 結核分枝桿菌耐乙胺丁醇診斷試驗的系統評價. 中國循證醫學雜志, 2010, 10(12): 1456-1460. doi: 10.7507/1672-2531.20100612 復制

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2.	The WHO/IUATLD Global Project on Anti-Tuberculosis Drug Resistance Surveillance: Anti-Tuberculosis drug resistance in the world, report number 2 Volume. Geneva; 2004.
3.	世界衛生組織. 結核病診斷: 全球需求與市場潛力. [EB/OL]. (2007-03-22) [2007-8-10]. http://bioop.com/dedecms3/html/shengwuqianyan/2006/1028/13557.html.
4.	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 Methodol, 2003, 3: 25.
5.	Musa HR, Ambroggi M, Souto A, et al. Drug susceptibility testing of mycobacterium tuberculosis by a nitrate reductase assay applied directly on microscopy-positive sputum samples. J Clin Microbiol, 2005, 43(7): 3159-3161.
6.	Martin A, Montoro E, Lemus D, et al. Multicenter evaluation of the nitrate reductase assay for drug resistance detection of Mycobacterium tuberculosis. J Clin Microbiol, 2005, 63(2): 145-150.
7.	Lemus D, Montoro E, Echemendía M, et al. Nitrate reductase assay for detection of drug resistance in Mycobacterium tuberculosis:simple and inexpensive method for low-resource laboratories. J Clin Microbiol, 2006, 55(Pt 7): 861-863.
8.	El-Sayed Zaki M, Goda T. Rapid phenotypic assay of antimycobacterial susceptibility pattern by direct mycobacteria growth indicator tube and phage amplified biological assay compared to BACTEC 460 TB. Tuberculosis(Edinb), 2007, 87(2): 102-108.
9.	Garrigó M, Aragón LM, Alcaide F, et al. Multicenter laboratory evaluation of the MB/BacT mycobacterium detection system and the BACTEC MGIT 960 system in comparison with the BACTEC 460TB system for susceptibility testing of mycobacterium tuberculosis. J Clin Microbiol, 2007, 45(6): 1766-1770.
10.	Bemer P, Palicova F, Rüsch-Gerdes S, et al. Multicenter Evaluation of Fully Automated BACTEC Mycobacteria Growth Indicator Tube 960 System for Susceptibility Testing of Mycobacterium tuberculosis. J Clin Microbiol, 2002, 40(1): 150-154.
11.	卿克勤, 秦進, 周小平. BACTECMGIT960系統結核分枝桿菌藥物敏感測定功能評價. 華西醫學, 2004, 19(2): 203-204.
12.	馬曉薇, 胡忠義, 王潔, 等. 噬菌體法與BACTEC 960檢測結核分枝桿菌乙胺丁醇耐藥性的比較研究. 中華內科雜志, 2005, 44(3): 202-205.
13.	馬曉薇, 胡忠義, 崔振玲, 等. 結核分枝桿菌乙胺丁醇耐藥性的噬菌體測定. 中華傳染病雜志, 2004, 22(6): 377-381.
14.	Angeby KAK, Klintz L, Hoffner SE. Rapid and Inexpensive drug susceptibility feasting of mycobacterium tuberculosis with fl Nitrate Reductase Assay. J Clin Microbio1, 2002, 40(2): 553-555.
15.	劉宇紅, 王蘇民, 那希寬. 比例法測試結核分枝桿菌藥物敏感性的探討. 中國防癆雜志, 2002, (2): 89-92.

1. 世界衛生組織. 關于結核病的10個事實. [EB/OL]. (2007-03-22) [2007-8-10]. http://www.who.int/features/factfiles/tuberculosis/zh/index.html.
2. The WHO/IUATLD Global Project on Anti-Tuberculosis Drug Resistance Surveillance: Anti-Tuberculosis drug resistance in the world, report number 2 Volume. Geneva; 2004.
3. 世界衛生組織. 結核病診斷: 全球需求與市場潛力. [EB/OL]. (2007-03-22) [2007-8-10]. http://bioop.com/dedecms3/html/shengwuqianyan/2006/1028/13557.html.
4. 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 Methodol, 2003, 3: 25.
5. Musa HR, Ambroggi M, Souto A, et al. Drug susceptibility testing of mycobacterium tuberculosis by a nitrate reductase assay applied directly on microscopy-positive sputum samples. J Clin Microbiol, 2005, 43(7): 3159-3161.
6. Martin A, Montoro E, Lemus D, et al. Multicenter evaluation of the nitrate reductase assay for drug resistance detection of Mycobacterium tuberculosis. J Clin Microbiol, 2005, 63(2): 145-150.
7. Lemus D, Montoro E, Echemendía M, et al. Nitrate reductase assay for detection of drug resistance in Mycobacterium tuberculosis:simple and inexpensive method for low-resource laboratories. J Clin Microbiol, 2006, 55(Pt 7): 861-863.
8. El-Sayed Zaki M, Goda T. Rapid phenotypic assay of antimycobacterial susceptibility pattern by direct mycobacteria growth indicator tube and phage amplified biological assay compared to BACTEC 460 TB. Tuberculosis(Edinb), 2007, 87(2): 102-108.
9. Garrigó M, Aragón LM, Alcaide F, et al. Multicenter laboratory evaluation of the MB/BacT mycobacterium detection system and the BACTEC MGIT 960 system in comparison with the BACTEC 460TB system for susceptibility testing of mycobacterium tuberculosis. J Clin Microbiol, 2007, 45(6): 1766-1770.
10. Bemer P, Palicova F, Rüsch-Gerdes S, et al. Multicenter Evaluation of Fully Automated BACTEC Mycobacteria Growth Indicator Tube 960 System for Susceptibility Testing of Mycobacterium tuberculosis. J Clin Microbiol, 2002, 40(1): 150-154.
11. 卿克勤, 秦進, 周小平. BACTECMGIT960系統結核分枝桿菌藥物敏感測定功能評價. 華西醫學, 2004, 19(2): 203-204.
12. 馬曉薇, 胡忠義, 王潔, 等. 噬菌體法與BACTEC 960檢測結核分枝桿菌乙胺丁醇耐藥性的比較研究. 中華內科雜志, 2005, 44(3): 202-205.
13. 馬曉薇, 胡忠義, 崔振玲, 等. 結核分枝桿菌乙胺丁醇耐藥性的噬菌體測定. 中華傳染病雜志, 2004, 22(6): 377-381.
14. Angeby KAK, Klintz L, Hoffner SE. Rapid and Inexpensive drug susceptibility feasting of mycobacterium tuberculosis with fl Nitrate Reductase Assay. J Clin Microbio1, 2002, 40(2): 553-555.
15. 劉宇紅, 王蘇民, 那希寬. 比例法測試結核分枝桿菌藥物敏感性的探討. 中國防癆雜志, 2002, (2): 89-92.

《中國循證醫學雜志》

結核分枝桿菌耐乙胺丁醇診斷試驗的系統評價

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《中國循證醫學雜志》

結核分枝桿菌耐乙胺丁醇診斷試驗的系統評價

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