| 摘要: |
| 目的：系统评价床旁即时超声测量不同位置动脉△Vpeak对于容量反应状态的诊断价值。方法：检索PubMed、Embase、Medline、Cochrane Library、CBMdisc、万方数据库、中国知网和维普数据库,由2名检索员依据纳入和排除标准对从建库至2019年5月的相关文献进行筛选,对纳入文献进行质量评价和资料提取,研究质量评价标准为QUADAS条目,对符合质量标准的文献采用Stata15.0软件进行分析。结果：本研究共纳入15篇文献,肱动脉、颈动脉、主动脉和所有动脉的△Vpeak诊断容量反应性的Sen合并分别为0.71(0.63-0.78)、0.87(0.77-0.93)、0.83(0.74-0.91)和0.79(0.74-0.83)；Spe合并分别为0.85(0.78-0.90)、0.85(0.76-0.91)、0.84(0.73-0.91)和0.85(0.81-0.89)；+LR(95% CI)分别为4.7(3.1-7.0)、5.8(3.5-9.5)、5.1(2.9-8.8)和5.3(4.1-6.9)；-LR(95% CI)分别为0.34(0.26-0.44)、0.16(0.09-0.27)、0.21(0.13-0.32)和0.25(0.20-0.31)；DOR分别为14(8-25)、37(18-77)、24(10-58)和21(15,31)；AUC分别为0.86(95%CI为0.82-0.88),0.92(95%CI为0.90-0.94),0.89(95%CI为0.86-0.91)和0.89(95%CI为0.86-0.92)。漏斗图结果表明肱动脉、颈动脉、主动脉和所有动脉的纳入研究均无发表偏倚,P值分别为0.34、0.43、0.36和0.33。结论：△Vpeak可适用于危重症患者的容量反应性评估,其中颈动脉△Vpeak最为合适。 |
| 关键词: 动脉血流峰值流速变异率，容量反应性，床边即时超声，不同检测部位, 荟萃分析 |
| DOI： |
| 投稿时间：2019-07-30修订日期：2019-08-16 |
| 基金项目: |
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| Diagnostic accuracy of different artery peak velocity variation for prediction of fluid responsiveness: A meta-analysis |
| wang ning |
| () |
| Abstract: |
| Objective: To evaluate the diagnostic value of different artery peak velocity(△Vpeak) in predicting fluid responsiveness. Methods: Databases of PubMed, Embase, Medline, Cochrane Library, CBM, Wanfang, CNKI and Veipu were retrieved. According to the inclusion and exclusion criteria,the retrieved documents from the reservoir to May 2019 were screened by two search members. Referencing QUADAS entries, the quality of included literatures were evaluated. The original data included in the literatures were summarized. Stata 15.0 was used to analyze the related literatures. Results: A total of 15 articles were included in the study. The pooled sensitivity were estimated as 0.71(0.63-0.78), 0.87(0.77-0.93), 0.83(0.74-0.91)and 0.79(0.74-0.83); the pooled specificity were estimated as 0.85(0.78-0.90), 0.85(0.76-0.91), 0.84(0.73-0.91) and 0.85(0.81-0.89); the pooled positive likelihood ratios were estimated as 4.7(3.1-7.0), 5.8(3.5-9.5), 5.1(2.9-8.8) and 5.3(4.1-6.9); the pooled negative likelihood ratios were estimated as 0.34(0.26-0.44), 0.16(0.09-0.27), 0.21(0.13-0.32) and 0.25(0.20-0.31); the diagnosed odd ratio were 14(8-25), 37(18-77), 24(10-58) and 21(15,31); AUC of SROC were 0.86(0.82-0.88),0.92(0.90-0.94),0.89(0.86-0.91) and 0.89(0.86-0.92) for △Vpeak of brachial, carotid, aortic and all arteries, respectively. Conclusion: Ultrasonic measurement of artery △Vpeak, especially carotid artery, has a high value in predicting fluid responsiveness in critical patients. |
| Key words: △Vpeak, fluid responsiveness, point-of-care ultrasound, different artery, meta-analysis |
