床旁超声监测颈总动脉峰流速变异诊断机械通气状态下患者容量反应状态的meta分析  

Peak Velocity Variation of Common Carotid Artery by Bedside Ultrasound Monitoring Diagnosed Volume Responsiveness in Mechanically Ventilated Patients:A Meta-analysis

作　　者：裴颖皓[1] 冯颖 杨洋 周海琪[1] 耿艳霞 蒋华[1] 潘涛 王醒[1] PEI Yinghao;FENG Ying;YANG Yang;ZHOU Haiqi;GENG Yanzria;J IANG Hua;PAN Tao;WANG Xing(Department of Intensive Care Unit, Nanjing University of Traditional Chinese Medicine Affiliated Hospital of J ian- gsu Provincial Traditional Chinese Medicine, Nanjing Jiangsu 210029, China)

机构地区：[1]南京中医药大学附属江苏省中医院重症医学科,江苏南京210029 [2]南京中医药大学第一临床医学院

出　　处：《华南国防医学杂志》2018年第4期254-257,267,共5页Military Medical Journal of South China

基　　金：江苏省中医院院级课题(Y17058)

摘　　要：目的搜集现有文献证据对颈总动脉峰流速变异(Peak velocity variation of common carotid artery,△Vpeak-CA)对机械通气状态下患者容量反应状态的诊断价值进行系统评价。方法全面检索中国知网全文数据库(China National Knowledge Infrastructure,CNKI),PubMed,Embase,the Cochrane Database数据库,检索时限为建库至2017-08月。纳入符合要求的评估△Vpeak-CA对机械通气状态下患者容量反应状态诊断价值的临床对照试验,采用随机效应模型计算合并灵敏度、特异度、诊断比值比(95%CI),绘制受试者工作曲线,计算曲线下面积。运用QUADAS-2进行文献质量评价。结果研究共纳入4篇文献,其中包括194例患者。Meta分析显示合并灵敏度、特异度、诊断比值比分别为0.85(95%CI为0.77~0.92),0.86(95%CI为0.77~0.92),38.54(95%CI为16.69~89.00),受试者工作特征曲线下面积(the area under the receiver operating characteristic curve,AUROC)为0.93,各研究间无异质性(P=0.98,I2=0)。结论目前证据显示△Vpeak-CA对机械通气状态下患者容量反应状态具有较高诊断价值,值得进一步探究。Objective To collect and evaluate the published evidence on the diagnosetic value of peak velocity variation of common carotid artery（△Vpeak-CA）for predicting volume responsiveness in mechanically ventilated patients.Methods Literatures in China National Knowledge Infrastructure（CNKI）,PubMed,Embase,and the Cochrane Database of controlled trials were all retrieved from building to august 2017.Included literatures that met the requirements were assessed△Vpeak-CA for diagnostic value of volume responsiveness in mechanically ventilated patients of controlled clinical trials.The random effects model was used to calculate pooled values of sensitivity,specificity and diagnostic ratio（95% CI）.The area under receiver operating characteristic curve（AUROC）was estimated and area under the curve was calculated.Qualities of the literatures were assessed with the QUADAS-2.Results Four literatures were included in this study,including 194 patients.Meta analysis showed that pooled values of sensitivity,specificity and diagnostic ratio were0.85（95% CI 0.77-0.92）,0.86（95% CI 0.77-0.92）,38.54（95% CI 16.69-89.00）,respectively,and AUROC was 0.93.No inter-study heterogeneity was found（P=0.98,I2=0.0%）.Conclusion Current evidences suggest that△Vpeak-CA has a high diagnostic value of predicting volume responsiveness in mechanically ventilated patients.It is worthy of further studies.

关 键 词：颈总动脉峰流速变异 META分析 机械通气 超声监测 容量反应 

分 类 号：R56[医药卫生—呼吸系统]