血氧水平依赖磁共振成像对早期糖尿病肾病评估价值的Meta分析

Blood Oxygenation Leveldependent Imaging in Evaluation of Early Diabetic Nephropathy:Meta⁃Analysis

目的通过Meta分析系统评价血氧水平依赖(BOLD)磁共振成像对早期糖尿病肾病(EDN)的评估价值。方法检索PubMed、Cochrane library、CNKI、万方、维普和中国生物医学文献数据库,搜集BOLD对EDN评估的研究文献,检索时间为2013年1月至2023年11月。采用Revman5.4、Stata16.0软件进行汇总分析。结果最终纳入8篇文献,共476例EDN患者。汇总后EDN组肾皮质R^(2∗)值(CR^(2∗)值)显著高于对照组,加权均数差(WMD)=0.35[95%CI(0.18,0.51),P<0.001;I^(2)=70.3%,P<0.05];肾髓质R^(2∗)值(MR^(2∗)值)显著高于对照组,WMD=2.02[95%CI(1.67,2.38),P<0.001;I^(2)=87.2%,P<0.05]。EDN组内,阴性尿蛋白亚组CR^(2∗)值与对照组比较差异无统计学意义,WMD=0.15[95%CI(-0.08,0.38),P=0.64;I^(2)=0.0%,P=0.19];MR^(2∗)值显著高于对照组,WMD=1.89[95%CI(1.441,2.345),P<0.001;I^(2)=85.4%,P<0.05]。阴性尿蛋白亚组CR^(2∗)值与对照组比较差异无统计学意义,WMD=-0.03[95%CI(-0.29,0.24),P=0.85;I^(2)=74.3%,P<0.05];MR^(2∗)值显著高于对照组,WMD=1.22[95%CI(0.69,1.74),P<0.001;I^(2)=35.8%,P=0.18]。结论BOLD是一种准确、无创的成像技术,定量监测MR^(2∗)值有可能在EDN诊断及决策中发挥作用。

Objective To evaluate the value of blood oxygenation level⁃dependent(BOLD)magnetic resonance imaging for the assessment of early diabetic nephropathy(EDN)by Meta⁃analysis system.Methods PubMed,Cochrane library,CNKI,Wanfang,Wipu and China Biomedical Literature Database were searched from 2013.1 to 2023.11 to collect the research literature on BOLD assessment of EDN.Pooled analyses were performed using Revman 5.4 and Stata 16.0 soft⁃ware.Results 8 papers with 476 EDN patients were finally included.Pooled renal cortical R^(2∗)values(CR^(2∗)values)were significantly higher in the EDN group than in the control group,Weighted Mean Difference(WMD)=0.35[95%CI(0.18,0.51),P<0.001;I^(2)=70.3%,P<0.05];and renal medullary R^(2∗)values(MR^(2∗)values)were significantly higher than in the control group,WMD=2.02[95%CI(1.67,2.38),P<0.001;I^(2)=87.2%,P<0.05].Within the EDN group,the negative urinary protein subgroup had no difference in CR^(2∗)values compared with the control group,WMD=0.15[95%CI(-0.08,0.38),P=0.64;I^(2)=0.0%,P=0.19];its MR^(2∗)value was significantly higher than that of the control group,WMD=1.89[95%CI(1.441,2.345),P<0.001;I^(2)=85.4%,P<0.05].The CR^(2∗)values of the negative urinary protein subgroup did not differ from those of the control group,WMD=-0.03[95%CI(-0.29,0.24),P=0.85;I^(2)=74.3%,P<0.05];the MR^(2∗)values were significantly higher than those of the control group,WMD=1.22[95%CI(0.69,1.74),P<0.001;I^(2)=35.8%,P=0.18].Conclusion BOLD is an accurate,noninvasive imaging technique,and quantitative monitoring of MR^(2∗)values has the potential to play a role in EDN diagnosis and decision⁃making.