肺超声评分诊断早产儿支气管肺发育不良:Meta分析

Lung ultrasound score for diagnosis of bronchopulmonary dysplasia in premature infants:Meta-analysis

目的 采用meta分析方法评估肺超声评分(LUS)诊断早产儿支气管肺发育不良(BPD)的价值。方法 检索并筛选PubMed、Embase、Medline、Cochrane Library、中国知网、万方医学网和维普数据库自建库至2022年7月31日收录的关于LUS诊断早产儿BPD的文献并提取相关数据,将肺部超声检查时间分为出生后3天(3D)、1周(1W)及2周(2W)内,将诊断BPD时间分为出生28天(28D)和36周(36W,纠正胎龄后);据此将早产儿分为6组,采用Review manager 5.4及Meta-DiSc 1.4软件进行数据分析,观察LUS诊断早产儿BPD的价值。结果 共纳入11篇文献,包括490例BPD患儿。3D+28D组LUS诊断早产儿BPD的合并敏感度、合并特异度和合并曲线下面积(AUC)分别为0.76、0.76及0.82;3D+36W组合并敏感度及合并特异度分别为0.70及0.88;1W+28D组合并敏感度、合并特异度及合并AUC分别为0.66、0.77及0.84;1W+36W组分别为0.67、0.81及0.89;2W+28D组合并AUC为0.85;2W+36W组合并敏感度、合并特异度及合并AUC分别为0.76、0.86及0.79。结论 出生后早期行LUS可较好地诊断早产儿BPD。

Objective To observe the value of lung ultrasound score(LUS)for diagnosis of bronchopulmonary dysplasia(BPD)in premature infants using meta-analysis.Methods Literature about LUS for diagnosis of BPD in premature infants were searched in PubMed,Embase,Medline,Cochrane Library,CNKI,Wanfang Med Online and VIP Database from the establishment of database to July 31,2022.The articles were screened,and the relevant data were extracted.The time of lung ultrasound examination was divided into within 3 days(3D),1 week(1W)and 2 weeks after birth(2W),and the time of diagnosing BPD was divided into 28 days(28D)and 36 weeks after birth(36W,after correction of gestational age).Then the premature infants were divided into 6 groups,and the data were analyzed using Review manager 5.4 and Meta-DiSc 1.4,the value of LUS for diagnosis of BPD in premature infants was evaluated.Results Totally 11 articles were enrolled,including 490 premature infants with BPD.The combined sensitivity,combined specificity and combined area under the curve(AUC)of LUS for diagnosing BPD in premature infants of 3D+28D group was 0.76,0.76 and 0.82,the combined sensitivity and combined specificity of 3D+36W group was 0.70 and 0.88,respectively.The combined sensitivity,combined specificity and combined AUC of 1W+28D group was 0.66,0.77 and 0.84,of 1W+36W group was 0.67,0.81 and 0.89,respectively.The combined AUC of 2W+28D group was 0.85.In 2W+36W group,the combined sensitivity,combined specificity and combined AUC was 0.76,0.86 and 0.79,respectively.Conclusion Early postnatal LUS could be used for diagnosing BPD in premature infants.