颅脑超声对新生儿脑白质损伤诊断价值的Meta分析

    Diagnosis Value of Cerebral Ultrasound on White Matter Damage: A Meta Analysis

    • 摘要: 目的 用Meta分析方法评价颅脑超声对新生儿脑白质损伤早期诊断的价值。 方法 计算机检索PubMed、EMBASE、中国生物医学文献数据库、万方、维普和中国期刊全文数据库,纳入符合纳入标准的文献,采用Meta-disc软件进行数据分析。 结果 共纳入10个研究,10个研究结果存在异质性(灵敏度I2值为0.75,特异度I2值为0.91)。利用随机效应模型合并的诊断敏感度和特异度为97.0%(95.0%~98.0%)和97.4% (96.4%~98.2%),合并阳性似然比为36.24(9.67~135.83),合并阴性似然比为0.041(0.02~0.10),合并比值比为1 210.8(182.57~8 029.5)。加权受试者工作特征曲线下面积为0.994 2,标准误为0.012 5。纳入文献稳定性较好,漏斗图分析提示未见明显发表偏倚(P=0.07)。 结论 颅脑超声对新生儿脑白质损伤有较高的诊断价值。

       

      Abstract: Objectives A meta analysis was performed to determine the value and accuracy in diagnosis of white matter damage. Methods A comprehensive and systematic search was conducted in PubMed, EMBASE, CBM, Wanfang, Weipu and CJFD databases. A software called ‘Meta-disc’ was used to obtain pooled estimates. Results Ten articles were included. The included studies had heterogeneity(I2 of sensitivity=0.753, I2 of specificity=0.91). Mean sensitivity and specificity was 97.0% (95.0%~98.0%) and 97.4% (96.4%~98.2%), respectively. Summary positive likelihood ratio was 36.24(9.67~135.83), summary negative likelihood ratio was 0.041 (0.02~0.10) and summary diagnostic odds ratio was 1 210.8(182.57~8 029.5). The AUC of SROC was 0.994 2, SE=0.012 5. Sensitivity analysis demonstrated no disproportionate influences of individual studies. Deeks funnel plot suggested the publication bias was not significant(P=0.07). Conclusion SROC shows that cerebral ultrasound is of value in diagnosis of white matter damage.

       

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