Long Ling, Zhao Hao-Tian, Zhang Zhi-Yang, Wang Guang-Ying, Zhao He-Ling
Department of Intensive Care Unit, Hebei General Hospital, Hebei, China.
Medicine (Baltimore). 2017 Jan;96(3):e5713. doi: 10.1097/MD.0000000000005713.
Pneumonia is a common and serious infectious disease that can cause high mortality. The role of lung ultrasound (LUS) in the diagnosis of pneumonia is becoming more and more important.
In the present study, we collected existing evidence regarding the use of LUS to diagnose pneumonia in adults and conducted a systematic review to summarize the technique's diagnostic accuracy. We specifically searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Embase databases and retrieved outcome data to evaluate the efficacy of LUS for the diagnosis of pneumonia compared with chest radiography or chest computed tomography. The pooled sensitivity (SEN) and specificity (SPE) were determined using the Mantel-Haenszel method, and the pooled diagnostic odds ratio (DOR) was determined using the DerSimonian-Laird method. We also assessed heterogeneity of sensitivity, specificity, and diagnostic odds ratio using the Q and I statistics.
Twelve studies containing 1515 subjects were included in our meta-analysis. The SEN and SPE were 0.88 (95% CI: 0.86-0.90) and 0.86 (95% CI: 0.83-0.88), respectively. The pooled negative likelihood ratio (LR) was 0.13 (95% CI: 0.08-0.23), the positive LR was 5.37 (95% CI: 2.76-10.43), and the DOR was 65.46 (95% CI: 29.24-146.56). The summary receiver operating characteristic curve indicated a relationship between sensitivity and specificity. The area under the curve for LUS was 0.95.
LUS can help to diagnose adult pneumonia with high accuracy.
肺炎是一种常见且严重的传染病,可导致高死亡率。肺部超声(LUS)在肺炎诊断中的作用越来越重要。
在本研究中,我们收集了有关使用LUS诊断成人肺炎的现有证据,并进行了系统评价以总结该技术的诊断准确性。我们专门检索了Cochrane对照试验中央注册库(CENTRAL)、PubMed和Embase数据库,并检索了结局数据,以评估LUS与胸部X线摄影或胸部计算机断层扫描相比在肺炎诊断中的疗效。使用Mantel-Haenszel方法确定合并敏感度(SEN)和特异度(SPE),使用DerSimonian-Laird方法确定合并诊断比值比(DOR)。我们还使用Q和I统计量评估了敏感度、特异度和诊断比值比的异质性。
我们的荟萃分析纳入了12项研究,共1515名受试者。SEN和SPE分别为0.88(95%CI:0.86-0.90)和0.86(95%CI:0.83-0.88)。合并阴性似然比(LR)为0.13(95%CI:0.08-0.23),阳性LR为5.37(95%CI:2.76-10.43),DOR为65.46(95%CI:29.24-146.56)。汇总的受试者工作特征曲线表明了敏感度和特异度之间的关系。LUS的曲线下面积为0.95。
LUS有助于准确诊断成人肺炎。