目的 基于循证医学系统性评价飞行质谱鉴定临床分离真菌的准确度,并与常规方法准确度进行比较.方法 检索主要英文数据库PubMed、Cochrane、Web of Science,以及中文数据库CBM、万方、维普、知网数据库,检索飞行质谱鉴定临床分离真菌的原始文献.结果 经筛选后纳入19篇文献(6609株真菌),Meta分析结果显示飞行质谱鉴定真菌至种水平正确率为0.9368(95％CI=0.9091～0.9598),常规方法鉴定真菌至种水平正确率为0.9104(95％CI=0.8874～0.9340);对结果进行了亚组分析,主要包括:菌株类型、研究类型、样本处理方法、金标准检测范围、鉴定阈值等;敏感性分析表明结果稳定可靠,Begg和Egger's结果表明飞行质谱鉴定真菌不存在发表偏倚,常规方法鉴定真菌存在一定发表偏倚.结论 基质辅助激光解吸电离-飞行时间质谱系统(MALDI-TOF MS)方法对鉴定临床致病性真菌准确率较高,是临床常规方法的可靠替代方法.%Objective To determine the accuracy of clinical isolates based on evidence-based systematic evaluation of flight mass spectrometry and compare it with the accuracy of conventional methods.Methods The main English databases PubMed,Cochrane,Web of Science,and Chinese database CBM,Wanfang,Weipu,and HowNet database were searched for the original literatures of clinical isolates being identified by flight mass spectrometry.Results After screening,19articles(6609strains)were included.The results of meta-analysis showed that the correct rate of lidentification fungi to species was 0.9368(95％ CI=0.9091-0.9598)by flight mass spectrometry.The correct rate of lidentification fungi to species was 0. 9104(95％CI=0.8874-0.9340)by clinical routine methods.Subgroup analysis of the results,including:strain type,research type,sample processing method,gold standard detection range,identification threshold,etc..Sensitivity analysis showed stable and reliable results.Begg and Egger's results indicated that there was no publication bias in the identification of fungi by flight mass spectrometry,and conventional methods hadidentified a certain publication bias.Conclusion Matrix-assisted laser desorption ionization-time-of-flight mass spectrometry(MALDI-TOF MS)method is a reliable alternative to clinical routine methods for identifying clinical pathogenic fungi with high accuracy.
展开▼
