背景:目前无法获得诊断神经梅毒(NS)的金标准;脑脊液(CSF)和血液中的各种实验室参数可以协助诊断。
方法:PubMed,Embase,搜索了Cochrane图书馆.包括利用实验室测试来辅助NS诊断的研究。计算诊断性能的汇总指标及其各自的95%置信区间(CI)。我们使用优势指数来测试诊断测试的优越性。
结果:研究中包括11篇引文。白蛋白商,CSF-TPHA,CSF-EIA,CSF-LDH,CSF-WBC,CSF-CXCL13,FTA-ABS,CSF-PCR,RPR,CSF-TPPA,信任,和CSF-VDRL在纳入的研究中进行评估。敏感性的汇总估计,特异性,CSF-TPPA和CSF-VDRL的SROC及其各自的95%CI为0.97(0.17,1.00),0.84(0.62,0.95),0.93(0.91,0.95)和0.74(0.59,0.85),0.99(0.93,1.00),0.94(0.91,0.96),分别。CSF-TPHA表现出最高的相对灵敏度。CSF-VDRL表现出最高的特异性。CSF-TPHA,信任,CSF-VDRL,CSF-EIA,RPR以优势指数排名前五。
结论:CSF-TPHA,信任,CSF-VDRL,CSF-EIA,与其他模式相比,RPR和RPR表明检测NS的性能可接受。综合诊断策略在NS的诊断中仍然发挥着重要作用。
The gold standard for diagnosing
neurosyphilis (NS) is currently unavailable; various laboratory parameters in cerebrospinal fluid (CSF) and blood can assist in the diagnosis.
PubMed, Embase, and the Cochrane Library were searched. Studies utilizing laboratory tests to assist in the diagnosis of NS were included. The pooled indicators for diagnostic performance and their respective 95% confidence intervals (CIs) were calculated. We used the superiority index to test the superiority of a diagnostic test.
Eleven citations were included in the study. Albumin quotient, CSF-TPHA, CSF-EIA, CSF-LDH, CSF-WBC, CSF-CXCL13, FTA-ABS, CSF-PCR, RPR, CSF-TPPA, TRUST, and CSF-venereal diseases research laboratory (VDRL) were assessed in the studies included. The pooled estimates of sensitivity, specificity, AUC of SROC and their respective 95% CIs for CSF-TPPA and CSF-VDRL were 0.97 (0.17, 1.00), 0.84 (0.62, 0.95), 0.93 (0.91, 0.95) and 0.74 (0.59, 0.85), 0.99 (0.93, 1.00), 0.94 (0.91, 0.96), respectively. CSF-TPHA demonstrated the highest relative sensitivity. CSF-VDRL manifested the highest specificity. CSF-TPHA, TRUST, CSF-VDRL, CSF-EIA, and RPR ranked in the top five laboratory tests with superiority index.
CSF-TPHA, TRUST, CSF-VDRL, CSF-EIA, and RPR indicate acceptable performance in detecting NS compared to other modalities. Comprehensive diagnostic strategies still play a significant role in the diagnosis of NS.