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目的对我国日本血吸虫人体感染检测的常用IHA方法诊断效能进行综合评估。方法在中国知网(CNKI)、万方数据(Wanfang Data)、重庆维普(VIP)、中国生物医学文献数据库、PubMed、Web of Science、Scopus和Google Scholar中检索有关间接血凝试验(IHA)诊断日本血吸虫人体感染的全部文献,采用meta分析综合评价IHA检测日本血吸虫人体感染的诊断效能。结果共有14项研究纳入最终分析,IHA法诊断日本血吸虫人体感染的灵敏度为37.6%(95%CI:32.1%~43.3%)~95.1%(95%CI:83.5%~99.4%),特异度为34.7%(95%CI:33.2%~38.2%)~91.6%(95%CI:91.6%~95.6%)。不同研究间存在异质性,采用随机效应模型加权合并的敏感度、特异度、阳性似然比和阴性似然比分别为75.6%(95%CI:73.9%~77.7%)、73%(95%CI:72.4%~73.7%)、2.877(95%CI:2.106~3.931)和0.306(95%CI:0.196~0.48)。应用加权最小二乘法、一般最小二乘法和稳健法计算得出的IHA合并准确度为0.71、0.759和0.749,合并OR值分别为5.997、9.937和8.893,3种方法拟合的IHA法SROC曲线下面积分别为0.766、0.826、0.815;合并优势比DOR值为9.41(95%CI:4.88~18.182)。散点图中散点基本对称,纳入文献发表偏倚较小。结论 IHA法对日本血吸虫人体感染诊断效能较高,是适合在向血吸虫病传播阻断乃至消除迈进中应用的适宜技术。
Objective To evaluate the diagnostic efficacy of commonly used IHA methods for the detection of Schistosoma japonicum human infection in China. Methods The diagnosis of indirect hemagglutination test (IHA) was retrieved from CNKI, Wanfang Data, VIP from Chongqing, China Biomedical Literature Database, PubMed, Web of Science, Scopus and Google Scholar Japan Schistosoma infection in all the literature, the use of meta-analysis comprehensive evaluation of IHA detection of Schistosoma japonicum human infection diagnostic efficacy. Results A total of 14 studies were included in the final analysis. The sensitivity of the IHA method for the diagnosis of human schistosoma japonicum infection was 37.6% (95% CI: 32.1% -43.3%) to 95.1% (95% CI: 83.5% -99.4%) with a specificity of 34.7% (95% CI: 33.2% -38.2%) to 91.6% (95% CI: 91.6% -95.6%). The heterogeneity among different studies was 75.6% (95% CI: 73.9% ~ 77.7%), 73% (95% CI: 95% CI: % CI: 72.4% -73.7%), 2.877 (95% CI: 2.106-3.931) and 0.306 (95% CI: 0.196-0.48). The IHA combined accuracy calculated by the weighted least square method, the general least squares method and the robust method was 0.71, 0.759 and 0.749, respectively. The combined OR values were 5.997, 9.937 and 8.893, respectively. Area respectively 0.766,0.826,0.815; Merger ratio DOR 9.41 (95% CI: 4.88 ~ 18.182). Scatter scatter the basic symmetry, included in the publication of small bias. Conclusion The IHA method has a high diagnostic value for human schistosoma japonicum infection and is suitable for the application in blocking or even eliminating the spread of schistosomiasis.