近五年肺部超声诊断儿童肺炎价值的Meta分析

Lung ultrasound for the diagnosis of pneumonia in children in recent 5 years:a meta-analysis

目的系统评价肺部超声诊断儿童肺炎的准确性。方法检索PubMed、the Cochrane Library、EMbase数据库,搜集肺部超声诊断儿童肺炎的研究,检索时限均从2015年1月1日至2020年3月18日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Meta Disc 1.4、RevMan 5.3和Stata 15.0软件进行分析。结果共纳入12个诊断性试验,包含2484例患儿。Meta分析结果显示肺部超声诊断儿童肺炎的敏感度、特异度、阳性似然比、阴性似然比、诊断比值比分别为0.90(95%CI 0.88-0.91)、0.88(95%CI 0.85-0.90)、8.64(95%CI 3.79-19.72)、0.12(95%CI 0.06-0.26)、77.58(95%CI 28.39-211.99),综合受试者工作特征曲线下面积=0.96。亚组分析显示研究开展的部门、采用不同金标准、操作者经验差异对肺部超声诊断儿童肺炎准确性无影响。结论当前研究证实肺部超声对儿童肺炎诊断具有较高准确性。

Objective To assess the accuracy of lung ultrasound(LUS)to predict pneumonia in pediatric patients using meta-analysis.Methods The PubMed,the Cochrane Library,EMbase databases from January 2015 to March 2020 were searched.The retrieved outcome data to evaluate the efficacy of LUS for the diagnosis of pneumonia in patients under 18 years of age were included.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Meta-analysis was then conducted using MetaDisc 1.4,RevMan 5.3 and Stata 15.0 softwares.Results Twelve diagnostic studies were included,which involved 2484 patients.The results of meta-analysis showed that compared with the gold standard,the sensitivity,specificity,positive and negative likelihood ratios,diagnostic odds ratio of LUS were 0.90(95%CI 0.88-0.91),0.88(95%CI 0.85-0.90),8.64(95%CI 3.79-19.72),0.12(95%CI 0.06-0.26)and 77.58(95%CI 28.39-211.99),respectively.The area under the summary receiver operating characteri stic curve was 0.96.Subgroup analysis showed that there was no difference in LUS′s diagnostic accuracy for pneumonia with different department,different diagnostic gold standard,and different level of sonographer training.Conclusion Current evidence shows that LUS has a high accuracy in the diagnosis of pneumonia in children.