剪切波弹性成像对于评估中国人群2型糖尿病患者胫神经病变的Meta分析

Meta-analysis of shear wave elastography in the evaluation of tibial neuropathy in Chinese patients with type 2 diabetes

目的系统评估剪切波弹性成像对于中国人群2型糖尿病患者胫神经病变的诊断价值。方法通过系统检索PubMed、The Cochrane Library、EMbase、万方数据库、中国知网、维普网等数据库中的相关文献,采用Review Manager 5.3软件和QUADAS-2进行质量评价,采用Meta-disc 1.4和Stata 12.0软件进行分析。结果经筛选本研究共纳入文献8篇,其中检测SWE 5篇,检测SWV 3篇。对于指标SWE而言,合并后敏感性和特异性分别为0.850(95%CI:0.800~0.890)和0.850(95%CI:0.810~0.880),曲线下面积(AUC)为0.930,Q指数为0.865,同时合并诊断比值比为41.200;SWV合并后敏感性和特异性分别为0.805(95%CI:0.706~0.882)和0.876(95%CI:0.828~0.920)。Deek′s漏斗图示该研究发表偏倚差异无统计学意义(P>0.05)。结论剪切波弹性成像技术在糖尿病周围神经病变的筛查诊断方面具有较高的敏感性和特异性,具有较高的临床应用价值,可以有效地为临床诊疗提供依据。

Objective To systematically evaluate the diagnostic value of shear wave elastography for tibial neuropathy in Chinese patients with type 2 diabetes.Methods The relevant documents in PubMed,The Cochrane Library,EMbase,Wanfang Database,CNKI,and Weipu were systematically retrieved.Review Manager 5.3 software,and QUADAS-2 were used for quality evaluation.Meta-disc 1.4 and Stata 12.0 software were used for analysis.Results After the screening,8 articles were included,including 5 articles of SWE and 3 articles of SWV.The sensitivity and specificity of the combined indicator SWE was 0.850(95%CI:0.800,0.890)and 0.850(95%CI:0.810,0.880),respectively.The area under the curve(AUC)was 0.93,and the Q index was 0.865.At the same time,the combined diagnostic odds ratio was 41.200.The sensitivity and specificity of combined SWV were 0.805(95%CI:0.706,0.882),and 0.876(95%CI:0.828,0.920),respectively.Deek′s funnel showed that there was no statistically significant difference in the publication bias of the study(P>0.05).Conclusion Shear wave elastography has high sensitivity and specificity in the screening and diagnosis of diabetic peripheral neuropathy,has high clinical application value,and can effectively provide a basis for clinical diagnosis and treatment.