肺部超声在急诊科检测 COVID-19 的诊断性能：系统评价和荟萃分析。
The diagnostic performance of lung ultrasound for detecting COVID-19 in emergency departments: A systematic review and meta-analysis.
机构信息
Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, Chapel Allerton Hospital, University of Leeds, Leeds, UK.
Radiology and Medical Imaging Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.
出版信息
J Clin Ultrasound. 2022 Jun;50(5):618-627. doi: 10.1002/jcu.23184. Epub 2022 Mar 9.
PURPOSE
To perform a systematic review and meta-analysis of published literature investigating the use of lung ultrasound (LUS) on COVID-19 patients, in emergency point of care settings, and to determine its diagnostic value compared with lung computed tomography (LCT) diagnostic performance. Whilst using the real-time polymerase chain reaction test as the 'gold standard'.
METHODS
Literature searches were performed on MEDLINE, Embase, Web of Science, and PubMed databases for eligible studies. The LUS and LCT pooled diagnostic performance were measured using DerSimonian-Laird random effect method.
RESULT
Out of a total of 158 studies, 16 met the eligibility criteria and were included in this review. The pooled sensitivity, specificity, positive and negative likelihood ratios were 86.9%, 62.4%, 2.4 and 0.19, respectively for LUS and 93.5%, 72.6%, 3.3 and 0.05, respectively for LCT.
CONCLUSION
The lung ultrasound (LUS) demonstrated acceptable sensitivity but poor specificity when used independently to diagnose COVID-19 pneumonia patients in emergency departments, while the lung computed tomography showed higher performance. Thus, LUS can be used to supplement existing diagnostic tools and possibly for the triage of patients.
目的
对已发表的关于在急诊点使用肺部超声（LUS）检查 COVID-19 患者的文献进行系统评价和荟萃分析，并确定与肺部计算机断层扫描（LCT）诊断性能相比，其诊断价值。同时将实时聚合酶链反应测试作为“金标准”。
方法
在 MEDLINE、Embase、Web of Science 和 PubMed 数据库中进行文献检索，以确定符合条件的研究。使用 DerSimonian-Laird 随机效应方法测量 LUS 和 LCT 的汇总诊断性能。
结果
总共 158 项研究中，有 16 项符合入选标准并纳入本综述。LUS 的汇总敏感性、特异性、阳性和阴性似然比分别为 86.9%、62.4%、2.4 和 0.19，LCT 分别为 93.5%、72.6%、3.3 和 0.05。
结论
肺部超声（LUS）在急诊科独立用于诊断 COVID-19 肺炎患者时具有可接受的敏感性，但特异性较差，而肺部计算机断层扫描显示出更高的性能。因此，LUS 可用于补充现有的诊断工具，并可能用于患者分诊。
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