阴道毛滴虫病诊断检测的系统评价
Systematic review of diagnostic tests for vaginal trichomoniasis.
作者信息
Patel S R, Wiese W, Patel S C, Ohl C, Byrd J C, Estrada C A
机构信息
Section of General Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA.
出版信息
Infect Dis Obstet Gynecol. 2000;8(5-6):248-57. doi: 10.1155/S1064744900000375.
OBJECTIVE
To review critically and to summarize the evidence of diagnostic tests and culture media for the diagnosis of Trichomonas vaginitis.
METHODS
We performed a systematic review of literature indexed in MEDLINE of studies that used Trichomonas culture as the reference standard (9,882 patients, 35 studies). Level I studies (5,047 patients, 13 studies) fulfilled at least two of three criteria: 1) consecutive patients were evaluated prospectively, 2) decision to culture was not influenced by test results, and 3) there was independent and blind comparison to culture.
RESULTS
The sensitivity of the polymerase chain reaction technique (PCR) was 95% (95% CI 91% to 99%), and the specificity was 98% (95% CI 96% to 100%). One study was classified as Level I evidence (52 patients). The sensitivity of the enzyme-linked immunosorbent assay was 82% (95% CI 74% to 90%), and the specificity was 73% (95% CI 35% to 100%). The sensitivity of the direct fluorescence antibody was 85% (95% CI 79% to 90%), and the specificity was 99% (95% CI 98% to 100%). Sensitivities of culture media were 95% for Diamond's, 96% for Hollander, and 95% for CPLM.
CONCLUSIONS
The sensitivity and specificity of tests to diagnose trichomoniasis vary widely.
目的
严格评估并总结用于诊断滴虫性阴道炎的诊断测试和培养基的证据。
方法
我们对MEDLINE索引的以滴虫培养作为参考标准的研究文献进行了系统综述（9882例患者，35项研究）。I级研究（5047例患者，13项研究）满足以下三项标准中的至少两项：1）对连续患者进行前瞻性评估；2）培养的决定不受测试结果影响；3）与培养进行独立且盲法比较。
结果
聚合酶链反应技术（PCR）的敏感性为95%（95%置信区间91%至99%），特异性为98%（95%置信区间96%至100%）。一项研究被归类为I级证据（52例患者）。酶联免疫吸附测定的敏感性为82%（95%置信区间74%至90%），特异性为73%（95%置信区间35%至100%）。直接荧光抗体的敏感性为85%（95%置信区间79%至90%），特异性为99%（95%置信区间98%至100%）。培养基的敏感性分别为：戴蒙德培养基95%，霍兰德培养基96%，CPLM培养基95%。
结论
诊断滴虫病的测试的敏感性和特异性差异很大。
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