基于 CT 的肺动脉与主动脉比值测量在合并肺动脉高压的慢性阻塞性肺疾病中的诊断价值：系统评价和荟萃分析。
Diagnostic value of computed tomography-based pulmonary artery to aorta ratio measurement in chronic obstructive pulmonary disease with pulmonary hypertension: A systematic review and meta-analysis.
机构信息
Department of Respiratory and Critical Care Medicine, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China.
出版信息
Clin Respir J. 2022 Apr;16(4):276-283. doi: 10.1111/crj.13485. Epub 2022 Mar 14.
OBJECTIVE
We conducted a meta-analysis to systematic assess the diagnostic value of computed tomography (CT)-based pulmonary artery to aorta (PA:A) ratio measurement in COPD with pulmonary hypertension (COPD-PH).
METHODS
Published studies referring to diagnostic accuracy of PA:A ratio for COPD-PH were screened out from PubMed, Embase, Web of science, China National Knowledge databases (CNKI), Wan fang databases, and VIP databases. We used bivariate random-effects model to estimate pooled sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (PLR and NLR, respectively), and diagnostic odds ratios (DOR). Summary receiver operating characteristic (SROC) curves and area under the curve (AUC) were also calculated to summarize the aggregate diagnostic performance.
RESULTS
Nine eligible studies were included and the pooled SEN was 69% (95% CI: 59 ~ 78), SPE was 85% (95% CI: 77 ~ 90), PLR was 4.5 (95% CI: 2.8 ~ 7.5), and NLR was 0.36 (95% CI: 0.26 ~ 0.51), respectively. DOR reached 13.00 (95% CI: 6.00 ~ 28.00), and value of AUC was 0.84 (95% CI: 0.81 ~ 0.87). Subgroup analysis indicated that when the value of PA:A ratio was equal or greater than one (PA/A ≥ 1), the combined SEN, SPE, AUC, and DOR was 69%, 89%, 0.90, and 19.65, respectively.
CONCLUSIONS
PA:A ratio is helpful for appraisal of COPD-PH, and PA/A ≥ 1 possessed prominent diagnostic accuracy.
目的
我们进行了一项荟萃分析，以系统评估基于计算机断层扫描（CT）的肺动脉与主动脉（PA：A）比值测量在慢性阻塞性肺疾病合并肺动脉高压（COPD-PH）中的诊断价值。
方法
从 PubMed、Embase、Web of Science、中国国家知识基础设施（CNKI）、万方数据库和 VIP 数据库中筛选出与 COPD-PH 的 PA：A 比值诊断准确性相关的已发表研究。我们使用双变量随机效应模型来估计汇总敏感性（SEN）、特异性（SPE）、阳性和阴性似然比（PLR 和 NLR，分别）以及诊断优势比（DOR）。还计算了汇总受试者工作特征（SROC）曲线和曲线下面积（AUC），以总结综合诊断性能。
结果
纳入了 9 项符合条件的研究，汇总的 SEN 为 69%（95%CI：59%78%），SPE 为 85%（95%CI：77%90%），PLR 为 4.5（95%CI：2.87.5），NLR 为 0.36（95%CI：0.260.51）。DOR 达到 13.00（95%CI：6.0028.00），AUC 值为 0.84（95%CI：0.810.87）。亚组分析表明，当 PA：A 比值等于或大于 1 时（PA/A≥1），合并的 SEN、SPE、AUC 和 DOR 分别为 69%、89%、0.90 和 19.65。
结论
PA：A 比值有助于评估 COPD-PH，且 PA/A≥1 具有显著的诊断准确性。
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