CAJ | 학술논문

目的：用 Meta 分析方法评价 CT 血管成像(CTA)对动脉瘤破裂所致蛛网膜下腔出血(SAH)的诊断价值。方法检索PubMed、MEDLINE、EMBASE、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)和万方数据库中的相关文献,结合Cochrane 协作网推荐内容制定纳入标准筛选文献,提取纳入研究的特征信息并用 QUADAS 评价纳入文献质量。通过 Meta-disc 1.4软件进行异质性检验,采用随机效应模型汇总灵敏度、特异度、阳性似然比、阴性似然比及95%可信区间；绘制受试者工作特性曲线(SROC)并计算曲线下面积(AUC)；通过 Stata12.0软件绘制漏斗图检测发表偏倚。结果纳入文献14篇,共1332例患者(1149个破裂动脉瘤)；合并灵敏度、特异度及95%可信区间分别为0.96(0.95~0.97)、0.99(0.97~1.00)；AUC 为0.99,Q 值为0.9584。结论CTA 具有较高的灵敏度、特异度和准确率,对颅内动脉瘤破裂导致的 SAH 具有较高的诊断价值。
목적：용 Meta 분석방법평개 CT 혈관성상(CTA)대동맥류파렬소치주망막하강출혈(SAH)적진단개치。방법검색PubMed、MEDLINE、EMBASE、중국기간전문수거고(CNKI)、중국생물의학문헌수거고(CBM)화만방수거고중적상관문헌,결합Cochrane 협작망추천내용제정납입표준사선문헌,제취납입연구적특정신식병용 QUADAS 평개납입문헌질량。통과 Meta-disc 1.4연건진행이질성검험,채용수궤효응모형회총령민도、특이도、양성사연비、음성사연비급95%가신구간；회제수시자공작특성곡선(SROC)병계산곡선하면적(AUC)；통과 Stata12.0연건회제루두도검측발표편의。결과납입문헌14편,공1332례환자(1149개파렬동맥류)；합병령민도、특이도급95%가신구간분별위0.96(0.95~0.97)、0.99(0.97~1.00)；AUC 위0.99,Q 치위0.9584。결론CTA 구유교고적령민도、특이도화준학솔,대로내동맥류파렬도치적 SAH 구유교고적진단개치。
Objective To evaluate the value of CT Angiography (CTA)in the diagnosis of cerebral aneurysms in patients with a-cute subarachnoid hemorrhage (SAH )with Meta analysis.Methods A systematic search in PubMed,MEDLINE,EMBASE, CNKI,CBM,WANFANG databases was performed.Criteria for inclusion were established based on validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic.The methodological quality of each study was eval-uated by QUADAS.Meta-Disc Version 1.4 software were used for heterogeneity test and the pooled weighted sensitivity,specifici-ty,positive likelihood ratio,negative likelihood ratio and 95% confidence intervals were calculated,receiver operating characteristic (SROC)and area under the curve(AUC)were obtained with random-effects models.Stata12.0 was used for the funnel plot to ana-lyze publication bias.Results Fourteen studies were included with a total of 1 332 patients and 1 149 ruptured cerebral aneurysms. The pooled weighted sensitivity and specificity of CTA with 95% confidence interval was 0.96(0.95-0.97)and 0.99(0.97-1.00) respectively.The AUC and the Q value of SROC was 0.99 and 0.958 4 respectively.Conclusion CTA has high sensitivity and spe-cificity in the diagnosis of cerebral aneurysms in patients with SAH,can be proposed as an important imaging diagnostic method.