Zhang Xu, Du Fang-Zhi, Wang Qian-Qiu, Zhang Rui-Li
Institute of Dermatology, Chinese Academy of Medical Science & Peking Union Medical College, National Center for STD Control, China Centers for Disease Control and Prevention, Nanjing 210042, China.
Department of Dermatology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China.
Sex Health. 2023 Oct;20(5):385-389. doi: 10.1071/SH22203.
We conducted a systematic review to analyse the consistency of nontreponemal-specific tests of Treponema pallidum in cerebrospinal fluid. We searched the PubMed, EMBASE, Web of Science, CNKI, Wanfang and Chongqing VIP databases. The inclusion criteria were studies conducted on nontreponemal-specific tests in cerebrospinal fluid (CSF) within the same population. Exclusion criteria were studies with incomplete data or where we were unable to obtain the full text, duplicate reports, case reports and studies without sensitivity or specificity results. We used kappa value analysis and McNemar's test to analyse study consistency. We initially collected a total of 198 articles and ultimately included six articles that involved 429 patients with neurosyphilis. The performance between venereal disease research laboratory tests (VDRL) and the reactive plasma regain or toluidine red serum unheated test was similar. The kappa value for consistency between VDRL and reactive plasma regain was >0.8 in three articles, and was 0.892 for consistency between VDRL and toluidine red serum unheated test in one article. Our results suggested that CSF-reactive plasma regain or CSF-toluidine red serum unheated test may serve as alternative tests in the diagnosis of neurosyphilis with CSF-VDRL.
我们进行了一项系统评价,以分析脑脊液中梅毒螺旋体非梅毒螺旋体特异性检测的一致性。我们检索了PubMed、EMBASE、Web of Science、中国知网、万方和维普数据库。纳入标准为在同一人群中对脑脊液中非梅毒螺旋体特异性检测进行的研究。排除标准为数据不完整的研究、无法获取全文的研究、重复报告、病例报告以及没有敏感性或特异性结果的研究。我们使用kappa值分析和McNemar检验来分析研究的一致性。我们最初共收集到198篇文章,最终纳入了6篇涉及429例神经梅毒患者的文章。性病研究实验室试验(VDRL)与反应性血浆重新检测或甲苯胺红不加热血清试验之间的性能相似。在3篇文章中,VDRL与反应性血浆重新检测之间一致性的kappa值>0.8,在1篇文章中,VDRL与甲苯胺红不加热血清试验之间一致性的kappa值为0.892。我们的结果表明,脑脊液反应性血浆重新检测或脑脊液甲苯胺红不加热血清试验可作为脑脊液VDRL诊断神经梅毒的替代检测方法。