肺部超声与X线对新生儿呼吸窘迫综合征诊断价值的Meta分析

Value of Lung Ultrasound and Chest X-Ray Examination in Diagnosis of Neonatal Respiratory Distress Syndrome: A Meta-Analysis

目的:应用Meta分析系统评价肺部超声与x线诊断新生儿呼吸窘迫综合征的价值。方法:使用计算机检索EMBASE、PubMed、The Cochrane Library、Web of Science等4个英文数据库,检索万方数据知识服务平台(Wanfang)、中国生物医学文献服务系统数据库(SinoMed)、中国知网(CNKI)和维普资讯中文期刊服务平台(VIP)等4个中文数据库获取文献,搜索肺部超声与x线诊断新生儿呼吸窘迫综合征诊断性试验的相关文献,检索时间从建库至2023年5月1日。严格筛选出符合纳入、排除标准的文献,提取资料,评价文献质量,采用Stata 14.0软件检测异质性,计算两种检查方法诊断新生儿呼吸窘迫综合征的合并敏感性、特异性、阳性似然比、阴性似然比及诊断比值比,绘制汇总受试者工作特征(SROC)曲线,获取曲线下面积。结果共纳入12篇诊断性试验的文献(1314名新生儿);Meta分析结果显示,肺部超声与x线诊断新生儿呼吸窘迫综合征的合并敏感性、特异性、阳性似然比、阴性似然比及诊断比值比分别为0.94、0.95、19.9、0.07、296和0.85、0.88、7.1、0.17、42;SROC曲线下面积分别为0.98和0.93,差异无统计学意义。结论:肺部超声诊断新生儿呼吸窘迫综合征的敏感性高于x线,具有更好的临床应用价值。

Objective: To assess the diagnostic value of lung ultrasound and chest x-ray examination for neona-tal respiratory distress syndrome by Meta-analysis. Methods: Literatures about the diagnostic tests of neonatal respiratory distress syndrome with lung ultrasound and chest x-ray examination were retrieved in databases including Pub Med, Cochrane Library, Embase, Web of science, CNKI, VIP, Si-noMed and Wanfang Data Service Platform, and were dated from the establishment of database to 1 May 2023. The literatures that comply with the inclusion and exclusion criteria were screened out strictly, extracted data and the quality of literature was assessed. Using the Stata 14.0 software de-tected heterogeneity, the combined sensitivity, specificity, positive likelihood ratio, negative likeli-hood ratio and diagnostic ratio of the two methods for the diagnosis of neonatal respiratory distress syndrome were calculated, and the SROC curves was drawn, and the area under the SROC curve was obtained. Results: Totally 12 diagnostic tests and 1314 neonatal were involved. The results of Me-ta-analysis showed that the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for neonatal respiratory distress syndrome diagnosis with lung ultra-sound and chest x-ray examination were 0.94, 0.95, 19.9, 0.07, 296 and 0.85, 0.88, 7.1, 0.17, 42, re-spectively. The areas under SROC curves were respectively 0.98 and 0.93;there was no significant difference. Conclusion: Comparing with chest x-ray examination, lung ultrasound has better diag-nostic value for neonatal respiratory distress syndrome.