腺苷负荷超声心动图诊断冠心病的Meta分析

Adenosine stress echocardiography diagnosis of coronary heart disease:A Meta-analysis

目的采用Meta分析评价腺苷负荷超声心动图(ASE)对冠心病的诊断价值。方法检索1994—2007年国内外公开发表的有关ASE诊断冠心病的文献,按Cochrane协作网推荐的方法进行Meta分析。结果共纳入12篇文献,ASE对冠心病诊断的敏感性为0.69～0.94,特异性为0.71～1.00。合并灵敏度和特异度分别为0.81(95%CI0.77～0.85)、0.83(95%CI0.78～0.87),合并阳性和阴性似然比分别为4.81(95%CI3.65～6.33)、0.22(95%CI0.18～0.28),SROC曲线下面积为0.8968±0.0151。结论ASE对冠心病具有中等偏高的临床诊断价值。

Objective To evaluate Meta-analysis in assessing the overall diagnostic value of adenosine stress echocardiography（ASE）in patients with coronary heart disease（CHD）.Methods Relevant English and Chinese articles about ASE for assessing diagnostic accuracy of CHD were collected from the literatures published from 1994 to 2007 in China and abroad.Meta-analysis was conducted with the method recommended by the Cochrane Collaboration.Results Twelve papers were included.The reported sensitivity of ASE for the diagnosis of CHD ranged from 0.69 to 0.94,and the specificity ranged from 0.71 to 1.00.The pooled weighted sensitivity and specificity was 0.81（95%CI 0.77—0.85）and 0.83（95%CI 0.78—0.87）,respectively;and the pooled positive and negative likelihood ratio was 4.81（95%CI 3.65—6.33）and 0.22（95%CI 0.18—0.28）,respectively.The area under the curve of the summary receiver operating characteristic was 0.8968±0.0151.Conclusion ASE is medium to highly accurate in the diagnosis of CHD.