定量超声对骨质疏松症诊断价值的Meta分析

Quantitative ultrasound for the diagnosis of osteoporosis: a meta analysis

目的系统评价定量超声应用于骨质疏松症诊断的临床价值。方法荟萃分析,采用Cochrane系统评价的方法,检索Medline(1966～2011年)、EMbase(1966～2010年)、Cochrane图书馆(2010年)及中国生物医学文献数据库CBM(1979～2010年)有关采用定量超声诊断骨质疏松症的临床对照研究文献资料,按照纳入和排除标准限定研究对象,通过QUADAS评分量表进行文献质量评估后,使用Meta-disc 1.4统计软件进行Meta分析,计算汇总敏感性、特异性及其95%可信区间,绘制汇总受试者操作特性曲线,综合评价定量超声应用于骨质疏松症诊断的临床价值。结果共纳入使用定量超声诊断骨质疏松症的临床对照研究11项(共2219例),汇总敏感性为76%(95%CI,73%～79%),汇总特异性为70%(95%CI,68%～73%),汇总的曲线下面积为0.8232,Q值为0.7565。结论定量超声用于诊断骨质疏松症具有较高的敏感性且特异性尚可,但尚需更多大样本、多中心临床对照试验数据支持。

Objective To evaluate the diagnostic value of quantitative ultrasound in osteoporosis. MethodsThe clinical literatures concerning quantitative ultrasound for diagnosis of osteoporosis compared to DXA were searched from Medline （1966 -2011 ） , EMbase （1966 -2010） , the Coehrane Library （2010） , and CBM （1979 -2010） , according to Cochrane evaluation guidelines. The subjects were chosen according to the inclusive and exclusive criteria. Quality of literatures was evaluated by QUADAS table. The meta- analysis was performed by Meta-dise 1.4 statistical software. Results Only 11 literatures were included in this meta-analysis （2219 cases ）. Summary sensitivity of quantitative ultrasound for the diagnosis of osteoporosis was 76% （95% CI, 73% -76% ） , and the summary specificity was 70% （95% CI, 68% - 73% ）. The area under SROC curve was 0. 8232, and Q index was 0. 7565. Conclusion Quantitative ultrasound has a relatively high sensitivity and specificity for the diagnosis of osteoporosis. However, large sample and multi - center clinical trails are required for further analysis.