摘要

BACKGROUND:To reduce the risk of drug-induced haemolysis, all patients should be tested for glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd) prior to prescribing primaquine (PQ)-based radical cure for the treatment of vivax malaria. This systematic review and individual patient meta-analysis assessed the utility of a qualitative lateral flow assay from Access Bio/CareStart (Somerset, NJ) (CareStart Screening test for G6PD deficiency) for the diagnosis of G6PDd compared to the gold standard spectrophotometry (International Prospective Register of Systematic Reviews [PROSPERO]: CRD42019110994). METHODS AND FINDINGS:Articles published on PubMed between 1 January 2011 and 27 September 2019 were screened. Articles reporting performance of the standard CSG from venous or capillary blood samples collected prospectively and considering spectrophotometry as gold standard (using kits from Trinity Biotech PLC, Wicklow, Ireland) were included. Authors of articles fulfilling the inclusion criteria were contacted to contribute anonymized individual data. Minimal data requested were sex of the participant, CSG result, spectrophotometry result in U/gHb, and haemoglobin (Hb) reading. The adjusted male median (AMM) was calculated per site and defined as 100% G6PD activity. G6PDd was defined as an enzyme activity of less than 30%. Pooled estimates for sensitivity and specificity, unconditional negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were calculated comparing CSG results to spectrophotometry using a random-effects bivariate model. Of 11 eligible published articles, individual data were available from 8 studies, 6 from Southeast Asia, 1 from Africa, and 1 from the Americas. A total of 5,815 individual participant data (IPD) were available, of which 5,777 results (99.3%) were considered for analysis, including data from 3,095 (53.6%) females. Overall, the CSG had a pooled sensitivity of 0.96 (95% CI 0.90-0.99) and a specificity of 0.95 (95% CI 0.92-0.96). When the prevalence of G6PDd was varied from 5% to 30%, the unconditional NPV was 0.99 (95% CI 0.94-1.00), with an LR+ and an LR- of 18.23 (95% CI 13.04-25.48) and 0.05 (95% CI 0.02-0.12), respectively. Performance was significantly better in males compared to females (p = 0.027) but did not differ significantly between samples collected from capillary or venous blood (p = 0.547). Limitations of the study include the lack of wide geographical representation of the included data and that the CSG results were generated under research conditions, and therefore may not reflect performance in routine settings. CONCLUSIONS:The CSG performed well at the 30% threshold. Its high NPV suggests that the test is suitable to guide PQ treatment, and the high LR+ and low LR- render the test suitable to confirm and exclude G6PDd. Further operational studies are needed to confirm the utility of the test in remote endemic settings.

译文

背景: 减少药物致溶血,所有患者应检查月-磷酸葡萄糖脱氢酶 (G6PD) 缺乏症 (G6PDd) 之前订明伯氨喹 (PQ) 基于根治治疗间日疟的。这个系统评价和个别病人分析评估实用质量侧流试验获得生物/CareStart (Somerset,NJ) (CareStart 初筛 G6PD 缺) 诊断 G6PDd 比金标法 (国际登记册的系统性综述 [普罗斯]: CRD42019110994)。方法和结果: 文章发表论文 PubMed 2019年9月27日 2011年1月1日和之间进行筛选。文章报告业绩的标准 CSG 静脉和毛细血管的血液样本,前瞻性和考虑分光光度测定的标准 (使用套件三位一体的生物技术 PLC,威克洛、爱尔兰) 都包括在内。文章的作者达到资格标准进行联系,以提供匿名个人数据。最低数据要求的性的参与者,南方电网,测定结果的 U/gHb 和血红蛋白 (Hb)。调整后的男性平均 (AMM) 计算每个站点和定义 100% G6PD 活动。G6PDd 被定义为一种酶活性低于 30%。联合估计的敏感性和特异性,无条件的预测值 (NPV) 、阳性似然比,阴性似然比 (LR) 南方电网计算比较结果的光度法测定了二元随机效应模型。对符合条件的执行情况发表文章、个人月的研究资料,来自东南亚的月、月从非洲和美洲的月。共有 5,815 个人参加数据 (IPD) 是可用的,5,777 的效果 (99.3%) 被视为进行分析,包括数据的 3,095 (53.6%) 是女生。总的来说,南方电网的集合的敏感性为 0.96 (95% CI 0.90 ~ 0.99),特异度 0.95 (95% CI 0.92 ~ 0.96)。当 G6PDd 盛行的是从 5% 到 30% 不等,无条件的现值为 0.99 (95% CI 0.94 ~ 1.00), 用 LR 的 LR-18.23 (95% CI 13.04 ~ 25.48) 和 0.05 (95% CI 0.02 ~ 0.12)。表现明显好于男生,女生 (p = 0.027),但样本,从毛细管之间差异均无显著性意义或静脉血 (p = 0.547)。研究的限制因素包括缺乏广泛的区域代表性的数据和南方电网的科研条件下所产生的结果,因此可能不反映业绩的程序设置。结论: 南方电网的表现良好,30% 的门槛。它采用净现值意味着测试适用于导 PQ,和高 LR 和低的 LR-G6PDd 渲染测试适用于确认和排除。进一步的业务需要开展研究,以确认是否有用的测试在偏远地方的设置。

Glucose 6-phosphate

内分泌 细胞因子 临床研究术语
概述  :  

6-磷酸葡萄糖是在碳6上的羟基磷酸化的葡萄糖糖。它位于两个主要代谢途径的开始:糖酵解和磷酸戊糖途径。除了这两个代谢途径外,6-磷酸葡萄糖还可以转化为糖原或淀粉进行储存。对于大多数多细胞动物,这种储存以糖原的形式存在于肝脏和肌肉中,而对于大多数其他生物而言,这种储存在细胞内的淀粉或糖原颗粒中。 生产 葡萄糖:在细胞内,葡萄糖在第六个碳上的磷酸化产生6-磷酸葡萄糖。这由在大多数细胞中的催化酶-己糖激酶进行催化,并且,在高等动物中,

glucose   英 /ˈɡluːkəʊs; ˈɡluːkəʊz/   美 /ˈɡluːkoʊs,ˈɡluːkoʊz/

释    义   n. 葡萄糖;葡糖(等于dextrose)

例    句   Identifying the presence of brown fat is one thing, but activating it to burn more glucose is another.确定棕色脂肪的存在是一回事,但激活它让它燃烧更多葡萄糖是另一回事。

 

phosphate   英 /ˈfɒsfeɪt/   美 /ˈfɑːsfeɪt/

释    义   n. 磷酸盐;皮膜化成

例    句   They dissolved cobalt and phosphate in water and then zapped it with electricity through an electrode.他们把钴和磷酸盐溶解到水溶液中,然后,通过电极对它们进行电解。

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