肺脏超声对新生儿暂时性呼吸增快症诊断价值的Meta分析

Value of lung ultrasound in diagnosis of transient tachypnea of newborn:a Meta-analysis

目的采用Meta分析的方法评价肺脏超声在新生儿暂时性呼吸增快症中的诊断价值。方法检索PubMed数据库、Embase数据库、Springer、Cochrane library、万方数据库和中国知网收录的自建库至2018年8月发表的有关肺脏超声诊断新生儿暂时性呼吸增快症的中、英文文献。采用QUADAS2工具对文献进行质量评价,采用Meta-Disc1.4软件进行Meta分析,计算肺脏超声诊断新生儿暂时性呼吸增快症合并的敏感度、特异度、阳性似然比(positive likelihood ratio,PLR)、阴性似然比(negative likelihood ratio,NLR)和诊断比值比(diagnostic odds radio,DOR),绘制拟合受试者工作特征曲线(summary receiver operator characteristic curve,SROC)。结果共纳入8篇文献共1582例患儿,其中英文文献5篇、中文文献3篇。Meta分析结果显示各研究间存在异质性,采用随机效应模型分析,结果显示合并敏感度为0.70(95%CI 0.66~0.74),合并特异度为0.96(95%CI 0.94~0.97),合并PLR为18.71(95%CI 8.41~41.63),合并NLR为0.12(95%CI 0.05~0.29),合并DOR为279.96(95%CI 48.86~1604.22),SROC曲线下面积为0.99,Cochran-Q为0.95。结论肺脏超声对新生儿暂时性呼吸增快症有较高的诊断价值。

Objective To evaluate the value of lung ultrasound in diagnosis of transient tachypnea in newborns.Methods Chinese and English literature search regarding lung ultrasound for the diagnosis of transient tachypnea of the newborn were retrieved in the PubMed Database,Embase Database,Springer,Cochrane library,Wanfang Database and CNKI from inception to August 2018.The Quality Assessment of Diagnostic Accuracy Studies(QUADAS-2)tool was used to assess the quality of studies.The pooled sensitivity,specificity,positive likelihood ratio(PLR),negative likelihood ratio(NLR),and diagnostic odds radio(DOR)were calculated by Meta-Disc 1.4 software,and SROC curve was drawed.Results A total of eight articles(five in English and three in Chinese)involving 1582 patients were included.Meta-analysis showed heterogeneity among studies,and random effect model was used.The pooled sensitivity was 0.70(95%CI was 0.66~0.74),the pooled specificity was 0.96(95%CI was 0.94~0.97),PLR was 18.71(95%CI 8.41~41.63),NLR was 0.12(95%CI was 0.05~0.29),DOR was 279.96(95%CI was 48.86~1604.22),area under SROC(AUC)was 0.99,and Cochran-Q was 0.95,respectively.Conclusion Pulmonary ultrasound has a preferable value for diagnosis of transient tachypnea in newborns.