在患有腹部症状的患者中进行乳病的诊断测试:系统性审查
Daniëlle A W M van der Windt1, Petra Jellema, Chris J Mulder
1Arthritis Research UK National Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, UK. d.van.der.windt@cphc.keele.ac.uk
JAMA
|May 6, 2010
概括
在患有腹部症状的成年人中,精确诊断乳病依赖于高度敏感和特异性抗体测试. 建议IgA抗组织转胺酶和IgA抗内质抗体用于初级保健机构.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 诊断的准确性 诊断的准确性
背景情况:
- 结核病的诊断和管理通常涉及无质饮食,但症状呈现有所不同.
- 由于症状变化,在初级保健中应尽量减少对乳病的不必要诊断测试.
研究的目的:
- 在初级保健中评估成年人腹部症状的乳病各种测试的诊断性能.
- 总结关于在未经选择的人群中诊断乳病的诊断测试准确性的证据.
主要方法:
- 对MEDLINE和EMBASE数据库进行系统的文献审查,并通过手动参考搜索进行补充.
- 包括具有队列或嵌套病例对照设计的诊断研究,重点关注非急性腹部症状和低患乳病的成年人 (≤15%).
- 独立的质量评估和数据提取,使用双变量分析计算聚合灵敏度和特异性.
主要成果:
- 审查了16项研究 (N=6085);腹部症状表现差异很大.
- 针对IgA抗内蒙菌抗体的聚合灵敏度和特异性分别为0.90和0.99.
- 对IgA抗组织转质胺酶抗体的聚合灵敏度和特异性分别为0.89和0.98;IgA/IgG抗 Gliadin抗体显示了不同的结果.
结论:
- 抗体IgA抗组织转胺酶抗体和抗体IgA抗内膜性抗体显示出高灵敏度和特异性,用于诊断患有腹部症状的成年人患有腹腔疾病.
- 这些抗体测试是初级保健和未选定人群中准确诊断乳病的宝贵工具.
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