ATP介入核素心肌灌注显像诊断冠心病的Meta分析  

Radionuclide myocardial perfusion imaging with ATP intervention in the diagnosis of coronary heart disease： a Meta-analysis

作　　者：刘征[1] 于卫国[1] 陈金良[1] 任永梅[1] 李安均[1] 李小柱[1] 

机构地区：[1]北京军区北戴河疗养院核医学科,秦皇岛066100

出　　处：《中华核医学与分子影像杂志》2016年第6期538-541,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的 系统评价ATP介入核素MPI（ATP－MPI）诊断冠心病的临床价值。方法 用计算机辅以人工检索PubMed、EMbase、CBMdisc、维普、知网等数据库，收集自建库以来至2014年公开发表的关于ATP－MPI诊断冠心病的文献。由2位独立的研究人员根据纳入和排除标准筛选文献提取数据。采用Stata 12.0软件进行Meta分析。结果 最终纳入研究11个，患者968例。以患者为研究对象，纳入9篇文献共933例患者，ATP－MPI诊断冠心病的Se、Sp、LR＋、LR－及95% CI分别为0.89（0.82～0.94）、0.84（0.74～0.91）、6.00（3.25～9.91）、0.13（0.07～0.22），诊断比值比（DOR）为45.04；综合ROC（SROC）曲线AUC为0.94。以冠状动脉为研究对象，纳入6篇文献共1 079支冠状动脉，ATP－MPI探查冠状动脉狭窄的Se、Sp、LR＋、LR－及95% CI分别为0.83（0.71～0.91）、0.92（0.86～0.95）、10.00（5.58～16.99）、0.18（0.09～0.34），DOR为53.24，SROC AUC为0.94。结论 ATP－MPI诊断冠心病有较高的临床价值。Objective To assess the clinical value of MPI with ATP intervention （ATP-MPI） in the diagnosis of coronary heart disease （CHD）.Methods To collect published literatures on ATP-MPI studies for the diagnosis of CHD, the PubMed, the Excerpta Medica Database （EMbase）, Chinese Biomedical Literature Database （CBMdis）, Vip and China National Knowledge Infrastructure （CNKI） databases were searched with computer and manual method since the data were available until to 2014. According to the inclusion and exclusion criteria, the literatures were screened to extract data by two independent evaluators. Meta-analysis was conducted with Stata 12.0 software.Results A total of 11 studies involving 968 patients were included. In patient study, which included 9 literatures and 933 patients, the Se, Sp, LR＋ , LR- and 95% CI of ATP-MPI diagnosis of CHD were 0.89 （0.82-0.94）, 0.84 （0.74-091）, 6.00 （3.25-9.91）, 0.13 （0.07-0.22）, respectively. The diagnostic odds ratio （DOR） was 45.04. The AUC of summary ROC （SROC） curve was 0.94. In the coronary artery study, which included 6 literatures and 1 079 coronary arteries, the Se, Sp, LR＋ , LR- and 95% CI of ATP-MPI diagnosis of coronary stenosis were 0.83 （0.71-0.91）, 0.92 （0.86-0.95）, 10.00 （5.58-16.99）, 0.18 （0.09-0.34）, respectively. The DOR was 53.24 and the SROC AUC was 0.94.Conclusion ATP-MPI has a significant value in the diagnosis of CHD.

关 键 词：冠状动脉疾病 腺苷三磷酸 体层摄影术 发射型计算机 单光子 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]