肺脏超声对新生儿呼吸窘迫综合征诊断价值的Meta分析

Meta-analysis of lung ultrasound for the diagnosis of neonatal respiratory distress syndrome

目的采用Meta分析方法评价肺脏超声对新生儿呼吸窘迫综合征的诊断价值。方法检索Pub Med、Cochrane library、Embase、Springer、CNKI和万方数据库,按照诊断性试验的纳入和排除标准,获取符合本研究要求的文献,检索时间为建库至2017年4月。对文献质量进行QUADAS2标准评价,采用Meta-Disc 1.4软件进行统计学分析,评价肺脏超声对新生儿呼吸窘迫综合征的诊断价值。结果共纳入7篇文献,包括6篇英文及1篇中文,纳入病例数673例。采用随机效应模型对纳入的研究进行统计分析,合并敏感度为0.99(95%CI 0.98~1.00),合并特异度为0.96(95%CI 0.93~0.98),合并阳性似然比为20.51(95%CI 6.05~69.54),合并阴性似然比为0.03(95%CI 0.01~0.06),合并诊断优势比为1024.52(95%CI 306.35~3426.31),拟合ROC曲线下面积0.9956,标准误为0.0083。结论肺脏超声对新生儿呼吸窘迫综合征有较高的诊断价值。

Objective To evaluate the diagnostic value of lung ultrasound for neonatal respiratory distress syndrome（NRDS） by Meta-analysis. Methods Pub Med, Cochrane library, Embase, Springer, CNKI and Wanfang Database were searched from database establishment to April 2017 to gathering articles according to the inclusion and exclusion criteria of diagnostic research. QUADAS2 was used to evaluate the quality of articles included. Meta-Disc 1.4 software was applied for the statistical analysis to evaluate the diagnostic value of lung ultrasound for NRDS. Results A total of 7 articles involving 673 cases were included. Random effect model was adopted for statistical analysis. The sensitivity was 0.99（95%CI 0.98-1.00）; the specificity was 0.96（95%CI 0.93-0.98）; the pooled positive likelihood ratio was 20.51（95%CI6.05-69.54）; the pooled negative likelihood ratio was 0.03（95%CI 0.01-0.06）; the pooled odds ratio was 1024.52（95%CI306.35-3426.31）; the area under SROC was 0.9956, the standard error was 0.0083. Conclusion The lung ultrasound has a relatively high diagnostic value for NRDS.