【摘要】 目的:用Meta分析的方法评价MRA对肾动脉性高血压诊断的价值。方法:搜索Pub/Medline、Ovid、CNKI及万方数据库检索所有用MRA对肾动脉性高血压进行诊断的文献,提取相关文献数据;对文献进行质量评估。数据分析采用Excel2003和MT软件,进行异值性检验,得到合并的诊断敏感性和特异性,合并的比数比(OR)值。结果:共检索到文献50篇,其中有非增强的2D、3DTOF和PCMRA技术文献32篇和动态增强MRA技术(DCEMRA)文献18篇,文献质量水平为1和2级。利用随机效应模型进行合并处理,DCEMRA技术的合并诊断敏感度和特异度分别为97.1%(CI:95.2%～98.5%)和94.8%(CI:93.4%～96%),合并比数比(DOR)为311.31(CI:173.23～559.45),加权SROC面积(AUC)为0.9875,SE为0.0031,Q值为0.9561,SE0.0072。非增强的MRA技术的合并敏感度为92.9%(CI:90.3%～95%),特异度为87.6%(CI:86%～89.2%),合并比数比(DOR)为98.411(CI:56.781～170.56);加权SROC曲线下面积(AUC)为0.9737,SE为0.0055,Q值为0.9259,SE0.0094,两方法的合并DOR和Q值及AUC比较(P<0.05)。结论:入选文献均有较高的水平。MRA有较高的准确性,而显示DCEMRA血管造影比非增强的MRA技术对肾动脉性高血压的诊断有较高的准确性。更多还原

【Abstract】 Objective:To summarize the accuracy of MRA for diagnosis of renal artery stenosis in patients suspected of having renovascular hypertension with meta analysis.Methods:50 Published studies were identified by Pub/Medline and Ovid database and CNKI and WANGFANG database to search renal artery stenosis of using MRA (including DCE MRA and non enhanced MRA,2D,3D TOF and PC MRA );A standard extractive data were obtained.Using software Excell2003 and MT,the summary DOR,summary sensitivity and specificity were calculated.Results:DCE MRA summary sensitivity and specificity were 97.1%(CI:95.2%～98.5%) and 94.8% (CI:93.4%～96%),respectively;summary diagnostic odds ratio (random effects model) was 311.31 (CI:173.23～559.45 );weighted AUC (area under curve) was 0.9875; Q* was 0.9561,SE 0.0072.Non-enhanced MRA summary sensitivity and specificity were 92.9% (CI:90.3%～95%)and 87.6% (CI:86%～89.2%),respectively;summary diagnostic odds ratio (Random effects model) was 98.411 (CI:56.781～170.56);Weighted AUC (area under curve) was 0.9737,SE 0.0055,Q* was 0.9259,SE 0.0094;DOR,Q* and AUC shows P<0.05,respectively.Conclusion:The papers were of good qualities.MRA has high accuracy for diagnosis of renal artery in renovascular hypertension and is a good modality for patients,especially DCE-MRA.更多还原