摘要
目的应用meta分析对腰椎CT值诊断骨质疏松症进行评价。方法检索包括PubMed、Cochrane Library、Web of Science、中国知网、万方及维普等中外数据库中关于腰椎CT值诊断骨质疏松患者的相关研究并提取基本资料和四格表数据(检索时限从建库至2021年12月),利用诊断试验质量评价工具(QUADAS-2)评价纳入研究的偏倚风险。采用Review Manager 5.4、Meta-Disc 1.4进行meta分析。结果本文总共纳入13篇文献,腰椎CT值诊断骨质疏松症按照椎体不同分为L1、L2、L3、L4、L5和L1-L4椎体平均值6个组,因L5和L1-L4椎体纳入的数据各只有一组,因此未进行效应量合并。L1其汇总敏感度为0.75(95%CI:0.72-0.77),汇总特异度为0.72(95%CI:0.70-0.73),拟合SROC曲线下面积为0.8126。L2汇总敏感度为0.73(95%CI:0.70-0.77),汇总特异度为0.75(95%CI:0.73-0.77),拟合SROC曲线下面积为0.8010。L3汇总敏感度为0.78(95%CI:0.75-0.81),汇总特异度为0.72(95%CI:0.70-0.74),拟合SROC曲线下面积为0.7935。L4汇总敏感度为0.76(95%CI:0.73-0.79),汇总特异度为0.73(95%CI:0.70-0.75)。结论腰椎CT值在人群中进行骨质疏松症的筛查方面具有一定意义,而其确诊骨质疏松症的能力不佳,确诊还需结合其他检查结果综合分析。
Objective To assess the efficacy of computed tomography(CT)values of lumbar spine in diagnosing osteoporosis(OP)by meta-analysis.Methods PubMed,Cochrane Library,Web of Science,CNKI,Wanfang and VIP Data(from the date of each database established to December,2021)were searched for the studies regarding diagnostic accuracy of CT values of lumbar spine for OP,and the general information and the fourfold table data were extracted.The Quality Assessment of Diagnostic Accuracy Studies-2(QUADAS-2)was used to evaluate the risk of bias of the included studies.Meta-analysis was performed using Review Manager 5.4 and Meta-Disc 1.4.Results According to the vertebral bodies size,the eligible 13 studies were assigned to 6 groups of L1,L2,L3,L4,L5,and the L1-L4 mean Hounsfield units(HU)values.Since only one set of data was included for L5 and the L1-L4 mean HU values,no effect size combination was performed.The pooled sensitivity,pooled specificity,and areas under curve(AUC)of summary receiver operating characteristic(SROC)for L1 were 0.75(95%CI:0.72-0.77),0.72(95%CI:0.70-0.73),and 0.8126 respectively;these values for L2 were 0.73(95%CI:0.70-0.77),0.75(95%CI:0.73-0.77),0.8010,respectively;and these for L3 were 0.78(95%CI:0.75-0.81),0.72(95%CI:0.70-0.74),0.7935,respectively.The pooled sensitivity and pooled specificity for L4 were 0.76(95%CI:0.73-0.79)and 0.73(95%CI:0.70-0.75),respectively.Conclusion CT value of lumbar spine has certain significance in screening OP in different populations,however,its diagnostic ability is poor,the OP diagnosis should be analyzed comprehensively combined with other inspection results.
作者
陈洁
陈树
尹玉峰
常新
武剑
Chen Jie;Chen Shu;Yin Yufeng;Chang Xin;Wu Jian(Department of Rheumatology and Immunology,the First Affiliated Hospital of Soochow University,Suzhou 215000,China)
出处
《临床荟萃》
CAS
2022年第11期970-976,共7页
Clinical Focus
