超声造影定量评价同种异体肾移植术后肾皮质功能的Meta分析  

Quantitative assessment of cortical function after allogeneic kidney transplantation by contrast-enhanced ultrasound:a systematic review and Meta-analysis

作　　者：张蓉 李旖旎 唐彬 代颜 李明星 夏纪筑 ZHANG Rong;LI Yini;TANG Bin;DAI Yan;LI Mingxing;XIA Jizhu(Department of Ultrasound Medicine,the Affiliated Hospital of Southwest Medical University,Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院超声医学科,四川省泸州市646000

出　　处：《临床超声医学杂志》2024年第11期921-926,共6页Journal of Clinical Ultrasound in Medicine

摘　　要：目的 系统评价超声造影(CEUS)定量评价同种异体肾移植术后肾皮质功能的临床价值。方法 计算机检索Cochrane Library、Embase、Medline、Web of Science、中国知网、万方、维普数据库,搜索CEUS定量评价同种异体肾移植术后肾皮质微循环的相关文献,检索时间均为2000年1月1日至2023年6月30日。由2名研究人员依据纳入和排除标准筛选文献,使用纽卡斯尔-渥太华量表(NOS)及诊断准确性研究质量评价量表-2(QUADAS-2)评价纳入文献质量。采用RevMan 5.4.1、R 4.0.3软件进行Meta分析。结果 最终纳入11篇文献,共计977例肾移植患者,其中肾功能障碍组340例,肾功能稳定组637例。NOS量表评价文献质量为6~8分。QUADAS-2评价文献总体质量为中至高等。Meta分析显示,与肾功能稳定组比较,肾功能障碍组曲线下面积、峰值强度均减低,达峰时间延长,差异均有统计学意义[SMD=-1.01(95%可信区间:-1.38~-0.63)、-0.75(95%可信区间:-1.07~-0.43)、0.33(95%可信区间:0.02~0.63),均P<0.05]。结论 CEUS可定量评价肾皮质微灌注的变化,为肾移植术后肾功能障碍的早期诊断提供参考。Objective To systematically evaluate the clinical value of contrast-enhanced ultrasound(CEUS)in quantitative assessment of cortical function after allogeneic kidney transplantation.Methods Databases including Cochrane Library,Embase,Medline,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang and VIP were searched for relevant studies on quantitative assessment of renal cortical microcirculation after allogeneic kidney transplantation by CEUS,covering the period from January 1,2000 to June 30,2023.Two researchers independently screened literature based on inclusion and exclusion criteria,and study quality was assessed by the Newcastle Ottawa Scale(NOS)and the Quality Assessment of Diagnostic Accuracy Studies-2(QUADAS-2).Meta-analysis was performed by RevMan 5.4.1 and R 4.0.3 software.Results A total of 11 studies involving 977 kidney transplant patients were enrolled,including renal dysfunction group(340 cases)and stable renal function group(637 cases).The quality of the studies assessed by the NOS ranged from 6 to 8 points.The overall quality of the studies was assessed as medium to high by QUADAS-2.Meta-analysis showed that compared with the stable renal function group,the area under the curve and peak intensity in the renal dysfunction group were reduced,and the peak time was prolonged,with statistically significant differences[SMD=-1.01(95%CI:-1.38~-0.63),-0.75(95%CI:-1.07~-0.43),0.33(95%CI:0.02~0.63),all P<0.05].Conclusion CEUS can quantitatively assess the changes in renal cortical microperfusion,providing a basis for early diagnosis of post-transplant renal dysfunction.

关 键 词：超声检查 造影剂 移植肾 肾皮质 微循环灌注 META分析 

分 类 号：R445.1[医药卫生—影像医学与核医学]