定量血流分数对冠状动脉狭窄诊断效果的meta分析

Diagnostic performance of quantitative flow ratio for coronary artery stenosis:A meta-analysis

目的:通过meta分析评价基于冠状动脉造影(CAG)的造影剂血流模型定量血流分数(cQFR)对冠状动脉狭窄的诊断效果。方法:通过对6个数据库[PubMed、EMbase、The Cochrane Library、CNKI、万方数据库和中国生物医学文献数据库(CBM)]的检索、文献数据摘录和meta分析(包括meta回归分析),评价cQFR的诊断效果。结果:共纳入32个研究,包括7209支血管。Meta分析显示,当冠状动脉血管中度狭窄时,cQFR诊断冠状动脉狭窄的总体灵敏度和总体特异度分别为0.86(95%CI 0.82~0.90)和0.91(95%CI 0.88~0.93),总体诊断比值比为60.22(95%CI 43.00~84.34),综合受试者工作特征曲线下面积为0.95(95%CI 0.92~0.96)。结论:cQFR对冠状动脉狭窄的诊断效果良好,与血流储备分数相比,其为无创性的检测且费用相对较低,因此具有良好的临床应用前景。

Objective To evaluate the diagnostic performance of contrast-flow quantitative flow ratio(cQFR)for coronary artery stenosis based on coronary arteriography(CAG).Methods Six database[PubMed,The Cochrane Library,EMbase,CNKI,WanFang Data and Chinese BioMedical Literature Database(CBM)]search,relevant data extraction and Meta analyses(including Meta regression analysis)were conducted to assessing the diagnostic performance of cQFR in coronary artery stenosis.Results Totally 35 studies were included with 7209 vessels.Random Meta analyses showed that the pooled sensitivity,pooled specificity,pooled diagnostic odds ratio of cQFR and the area under the summary receiver operating characteristic curve were 0.86(95%CI0.82-0.90),0.91(95%CI0.88-0.93),60.22(95%CI43.00-84.34)and 0.95(95%CI0.92-0.96)when coronary artery stenosis of a branch occupies no more than 80%.Conclusion cQFR has good diagnostic performance for coronary artery stenosis.Compared to fraction flow reserve(FFR),cQFR is noninvasive and less expensive,and therefore,has good clinical application prospect.