结核分枝杆菌耐乙胺丁醇诊断试验的系统评价_《中国循证医学杂志》

作者：

张志明 ¹ ,  张宗久 ² , 李培杰 ³ , 杨克虎 ² , 祝秉东 ⁴

1. 甘肃省中医学院附属医院（兰州 730000）；2. 兰州大学循证医学中心，兰州大学基础医学院（兰州 730000）；3. 兰州大学第二医院（兰州 730000）；4. 兰州大学结核病研究中心（兰州 730000）;

关键词：

结核分枝杆菌乙胺丁醇诊断试验系统评价 Meta分析

DOI：

10.7507/1672-2531.20100612

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价各种检测结核分枝杆菌耐乙胺丁醇诊断试验方法的准确性。
方法　计算机检索PubMed、EMbase等数据库，并手工检索相关期刊，全面收集结核分枝杆菌耐乙胺丁醇诊断试验的研究，依据QUADAS评价纳入诊断试验的质量，并对结果进行Meta分析。
结果　最终纳入9个研究。Meta分析结果显示：硝酸盐还原法与比例法相比，以及BACTEC MGIT 960与BACTEC 460 TB相比，其敏感度、特异度、阳性似然比、阴性似然比及SROC曲线下面积分别为92%、99%、30.50、0.13、0.9752和93%、92%、6.27、0.11、0.9；MB/BacT，噬菌体生物扩增法亦显示了较好的检验效能。
结论　硝酸盐还原试验可代替比例法作为结核分枝杆菌耐乙胺丁醇的筛查试验；BACTEC MGIT 960可代替BACTEC 460检测系统作为结核分枝杆菌耐乙胺丁醇的确诊试验。

引用本文： 张志明,张宗久,李培杰,杨克虎,祝秉东. 结核分枝杆菌耐乙胺丁醇诊断试验的系统评价. 中国循证医学杂志, 2010, 10(12): 1456-1460. doi: 10.7507/1672-2531.20100612 复制

1.	世界卫生组织. 关于结核病的10个事实. [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.	世界卫生组织. 结核病诊断: 全球需求与市场潜力. [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, 秦进, 周小平. BACTECMGIT960系统结核分枝杆菌药物敏感测定功能评价. 华西医学, 2004, 19(2): 203-204.
12.	马晓薇, 胡忠义, 王洁, 等. 噬菌体法与BACTEC 960检测结核分枝杆菌乙胺丁醇耐药性的比较研究. 中华内科杂志, 2005, 44(3): 202-205.
13.	马晓薇, 胡忠义, 崔振玲, 等. 结核分枝杆菌乙胺丁醇耐药性的噬菌体测定. 中华传染病杂志, 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.	刘宇红, 王苏民, 那希宽. 比例法测试结核分枝杆菌药物敏感性的探讨. 中国防痨杂志, 2002, (2): 89-92.

1. 世界卫生组织. 关于结核病的10个事实. [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. 世界卫生组织. 结核病诊断: 全球需求与市场潜力. [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, 秦进, 周小平. BACTECMGIT960系统结核分枝杆菌药物敏感测定功能评价. 华西医学, 2004, 19(2): 203-204.
12. 马晓薇, 胡忠义, 王洁, 等. 噬菌体法与BACTEC 960检测结核分枝杆菌乙胺丁醇耐药性的比较研究. 中华内科杂志, 2005, 44(3): 202-205.
13. 马晓薇, 胡忠义, 崔振玲, 等. 结核分枝杆菌乙胺丁醇耐药性的噬菌体测定. 中华传染病杂志, 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. 刘宇红, 王苏民, 那希宽. 比例法测试结核分枝杆菌药物敏感性的探讨. 中国防痨杂志, 2002, (2): 89-92.

《中国循证医学杂志》

结核分枝杆菌耐乙胺丁醇诊断试验的系统评价

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《中国循证医学杂志》

结核分枝杆菌耐乙胺丁醇诊断试验的系统评价

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