彩色多普勒超声诊断肾动脉狭窄的Meta分析

Meta-analysis of color Doppler ultrasonography in diagnosis of renal artery stenosis

目的探索彩色多普勒超声检查对肾动脉狭窄的诊断价值。方法计算机检索1995年1月至2013年8月国内外公开发表的以肾动脉造影检查结果为金标准的关于超声诊断肾动脉狭窄的中、英文文献,提取文献相关数据。根据Cochrane协作网推荐的方法对文献进行质量评价,并用Meta DiSc 1.4软件进行统计分析。结果共纳入文献10篇,彩色多普勒超声诊断肾动脉狭窄的合并敏感性和特异性分别为0.86（CI：0.83~0.89）、0.96（CI：0.95~0.97）,诊断比值比为141.08（CI：51.19~384.33）,合并阳性和阴性似然比分别为20.54（CI：8.80~47.93）、0.16（CI：0.12~0.21）,总受试者工作特征曲线下面积为0.9049。结论彩色多普勒超声检查对肾动脉狭窄具有较高临床诊断价值。

Objective To investigate the value of color Doppler ultrasonography（CDUS）in the diagnosis of renal artery stenosis（RAS）. Methods The literature retrieval was performed using computer which were published on both Chinese and international journals from January 1995 to August 2013 on color Doppler ultrasonography for the diagnosis of renal artery stenosis verified by renal arteriography. The related data were extracted. According to the diagnostic test criteria recommended by Cochrane Screening,the quality of the study methodologies was evaluated and meta-analysis was performed by Meta DiSc 1.4 software.Results Ten references met the inclusion criteria. On color Doppler ultrasonography for the diagnosis of renal artery stenosis,the pooled sensitivity and specificity were 0.86（CI：0.83~0.89）and 0.96（CI：0.95~0.97）,the pooled diagnostic odd ratio was 141.08（CI：51.19~384.33）,and the pooled positive and negative likelihood ratio were 20.54（CI：8.80~47.93）and 0.16（CI：0.12~0.21）. The area under the curve of the summary receiver operating characteristic（AUC）was 0.9049. Conclusion Color Doppler ultrasonography has great value on the diagnosis of renal artery stenosis.