肺脏超声检查诊断心源性呼吸困难的Meta分析

Lung ultrasound for the diagnosis of cardiogenic dyspnea:a meta-analysis

目的通过Meta分析探讨肺脏超声检查对心源性呼吸困难的诊断价值。方法检索PubMed、Web of science、EMbase、中国生物医学文献数据库、中国知网和万方数据库,检索时间为建库至2022年4月5日,共检索文献3938篇。采用QUADAS-2对纳入文献质量进行评价并提取数据,运用I2和Cochran-Q检验行异质性检验,采用Meta-Disc 1.4软件进行数据分析。结果共纳入18篇文献。采用随机效应模型进行Meta分析,敏感度合并值为0.83(95%CI:0.81~0.85),特异度合并值为0.85(95%CI:0.83~0.86),阳性似然比合并值为5.19(95%CI:3.3~8.18),阴性似然比合并值为0.20(95%CI:0.13~0.29),诊断比值比合并值为32.51(95%CI:17.21~61.41),SROC下曲线面积合并值为0.9181。结论肺脏超声诊断心源性呼吸困难的价值及准确性较高,可成为一种新的诊断工具,但需更大样本、更科学合理的前瞻性研究予以验证。

Objective To evaluate the diagnostic value of Pulmonary ultrasonography for cardiogenic dyspnea by Meta-analysis.Methods We searched PubMed,Web of Science,Embase,CBM,CNKI and WanFang Database from the database construction to April 52022,and 3938 articles were retrieved.The quality assessment of diagnostic accuracy studies(QUADAS-2)was used to evaluate the risk of bias of the included literature,then extract the data.Heterogeneity was assessed by I2 and Cochran-Q tests,and Meta-DISC 1.4 software was used to analyze data.Results A total of 18 literatures and 3558 cases were included.A random effect model was adopted for meta-analysis.The pooled sensitivity was 0.83(95%CI:0.81~0.85),the pooled specificity was 0.85(95%CI:0.83~0.86),the PLR was 5.19(95%CI:3.3~8.18),the NLR was 0.20(95%CI:0.13~0.29),the DOR was 32.51(95%CI:17.21~61.41),and the area under SROC was 0.9181.Conclusion Lung ultrasound has high accuracy and great value for the diagnosis of cardiogenic dyspnea,which can be used as a new method for diagnosing acute heart failure.However,it still needs to be verified by more scientific and reasonable prospective trials with larger samples.