多层螺旋CT血管成像诊断胸痛三联征价值的Meta分析  

Diagnostic value of multi-slice spiral computed tomography angiography for detecting chest pain triple: a meta-analysis

作　　者：郭奇虹[1] 雷军强[1] 王刚[1] 南江 史小男[1] 陈梓娴[1] 卢星如[1] GUO Qihong;LEI Junqiang;WANG Gang;NAN Jiang;SHI Xiaonan;CHEN Zixian;LU Xingru(Radiology Department,the First Hospital of Lanzhou University,Lanzhou,730000,P.R.Chin)

机构地区：[1]兰州大学第一医院放射科,兰州730000

出　　处：《中国循证医学杂志》2018年第7期670-675,共6页Chinese Journal of Evidence-based Medicine

基　　金：甘肃省科技厅科技支撑项目(编号:1604FKCA102)

摘　　要：目的系统评价多层螺旋CT血管成像(MSCTA)诊断胸痛三联征(CPT)的价值。方法计算机检索Pub Med、EMbase、The Cochrane Library、Web of Science、CNKI、CBM、Wan Fang Data和VIP数据库,搜集MSCTA诊断CPT的诊断性试验,检索时间从建库至2017年10月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 12.0软件进行Meta分析,计算其合并敏感度(Sen)、特异度(Spe)、阳性似然比(+LR)、阴性似然比(–LR)、诊断比值比(DOR),绘制受试者工作特征曲线(SROC)并计算曲线下面积(AUC)。结果共纳入11个研究。MSCTA诊断CPT的Sen_(合并)、Spe_(合并)、+LR_(合并)、–LR_(合并)、DOR和AUC分别为0.95[95%CI(0.91,0.98)]、0.97[95%CI(0.94,0.98)]、31.24[95%CI(15.63,62.43)]、0.05[95%CI(0.02,0.10)]、659.04[95%CI(236.73,1 834.71)]和0.99[95%CI(0.98,1.00)]。结论 MSCTA对诊断CPT具有较高的敏感性和特异性,诊断效能高。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。Objectives To systematically review clinical values of multi-slice spiral computed tomography angiography（MSCTA） in diagnosis of chest pain triple（CPT）. Methods Pub Med, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, VIP and Wan Fang Data databases were searched to collect diagnostic tests on CPT diagnosed by MSCTA from inception to October 2017. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed by Stata 12.0 software. The pooled weighted Sen, Spe,＋LR,-LR, and the DOR were calculated, SROC and AUC were drawn. Results A total of 11 diagnostic studies were included. The results of meta-analysis showed that the pooled Sen, Spe, ＋LR,-LR, DOR and AUC of MSCTA for diagnosing CPT were 0.95（95%CI 0.91 to 0.98）, 0.97（95%CI 0.94 to 0.98）, 31.24（95%CI 15.63 to 62.43）, 0.05（95%CI 0.02 to 0.10）, 659.04（95%CI 236.73 to 1 834.71） and 0.99（95%CI 0.98 to 1.00）, respectively. Conclusions MSCTA has high sensibility and specificity for diagnosing CPT. Due to limited quantity and quality of the included studies, more highquality studies are required to verify the above conclusion.

关 键 词：多层螺旋CT血管成像 胸痛三联征 诊断性试验 META分析 

分 类 号：R816.2[医药卫生—放射医学]