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Xpert MTB/RIF assay 检测结核性心包炎的诊断准确性:系统评价和荟萃分析。

Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A systematic review and meta-analysis.

机构信息

Department of Thoracic Surgery, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, Zhejiang, China.

Zhejiang Tuberculosis Diagnosis and Treatment Center, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Zhejiang Chinese Medicine and Western Medicine Integrated Hospital, Hangzhou, Zhejiang, China.

出版信息

PLoS One. 2021 Sep 10;16(9):e0257220. doi: 10.1371/journal.pone.0257220. eCollection 2021.

Abstract

OBJECTIVE

The purpose of this study was to evaluate the diagnostic efficacy of Xpert MTB/RIF for tuberculous pericarditis (TBP).

METHODS

We searched relevant databases for Xpert MTB/RIF for TBP diagnosis until April 2021 and screened eligible studies for study inclusion. We evaluated the effectiveness of Xpert MTB/RIF when the composite reference standard (CRS) and mycobacterial culture were the gold standards, respectively. We performed meta-analyses using a bivariate random-effects model, and when the heterogeneity was obvious, the source of heterogeneity was further discussed.

RESULTS

We included seven independent studies comparing Xpert MTB/RIF with the CRS and six studies comparing it with culture. The pooled sensitivity, specificity, and area under the curve of Xpert MTB/RIF were 65% (95% confidence interval, 59-72%), 99% (97-100%), and 0.99 (0.97-0.99) as compared with the CRS, respectively, and 75% (53-88%), 99% (90-100%), and 0.94 (0.92-0.96) as compared with culture, respectively. There was no significant heterogeneity between studies when CRS was the gold standard, whereas heterogeneity was evident when culture was the gold standard.

CONCLUSIONS

The sensitivity of Xpert MTB/RIF for diagnosing TBP was moderate and the specificity was good; thus, Xpert MTB/RIF can be used in the initial diagnosis of TBP.

摘要

目的

本研究旨在评估 Xpert MTB/RIF 检测结核性心包炎(TBP)的诊断效能。

方法

我们检索了截至 2021 年 4 月有关 Xpert MTB/RIF 诊断 TBP 的相关数据库,并筛选出符合纳入标准的研究。我们评估了 Xpert MTB/RIF 在复合参考标准(CRS)和分枝杆菌培养均为金标准时的有效性。我们使用双变量随机效应模型进行荟萃分析,当异质性明显时,进一步探讨异质性的来源。

结果

我们纳入了 7 项比较 Xpert MTB/RIF 与 CRS 的独立研究和 6 项比较 Xpert MTB/RIF 与培养的研究。Xpert MTB/RIF 的合并敏感性、特异性和曲线下面积(AUC)分别为 65%(95%置信区间,59%-72%)、99%(97%-100%)和 0.99(0.97-0.99),与 CRS 比较;与培养比较时,分别为 75%(53%-88%)、99%(90%-100%)和 0.94(0.92-0.96)。当 CRS 为金标准时,各研究间无显著异质性,而当培养为金标准时,异质性明显。

结论

Xpert MTB/RIF 诊断 TBP 的敏感性中等,特异性较好;因此,Xpert MTB/RIF 可用于 TBP 的初步诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e051/8432788/a959446e5bfd/pone.0257220.g001.jpg

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