【摘要】 目的 评估静脉肾盂造影(IVP)和多层螺旋CT尿路造影(MSCTU)对泌尿系统疾病的诊断价值。方法 检索Cochrane图书馆、PubMed、OVID、Embase数据库1990～2008年公开发表的英文文献,以及中国期刊网1998～2008年的中文文献,按照Cochrane协作网推荐的诊断试验的纳入标准筛选文献,提取纳入研究的特征信息。对2种方法进行异质性检验,并选择相应的效应模型对所有研究加权定量合并,计算汇总灵敏度和特异度及其95%可信区间。绘制汇总受试者工作特征曲线(SROC)并计算曲线下面积,进行敏感性分析。统计学分析采用Meta-Test和SPSS11.0软件。结果 按照纳入标准共获取文献13篇,其中有关MSCT诊断泌尿系统疾病者7篇,IVP为2篇,二者共同研究者4篇。2组研究均有异质性,但异质性均在允许范围内,按照随机效应模型对纳入文献行汇总分析。结果显示,MSCTU与IVP扫描的汇总灵敏度和特异度及95%可信区间分别为0.95(0.93～0.96)/0.95(0.85～0.98)、0.94(0.91～0.96)/0.61(0.57～0.65);二者的SROC曲线下面积(%)分别为:98.88%和68.57%。结论 汇总分析MSCT平扫加尿路造影与IVP扫描诊断泌尿系统疾病的研究显示,前者的诊断价值明显高于后者。更多还原

【Abstract】 Objective To assess the overall diagnostic value of multi-slice spiral CT urography(MSCTU) and intravenous pyelography(IVP) with MATA-analysis in the diagnosis of urinary tract diseases.Methods Articles published from 1990 to 2008 were searched in Cochrane library,PubMed,Embase database and OVID database for relevant English articles and in CNKI for Chinese articles since 1990.According to the criteria for diagnostic research published by Cochrane Method Group on screening and diagnostic tests,each article was critically appraised and screened,including the absolute numbers of true-positive,false-negative,truenegative,and false-positive.Statistical analysis was performed employing Meta-Test and SPSS 11.0.Heterogeneity was tested,Pooled weighted sensitivity and specificity and the corresponding 95 % CI were calculated.Summary receiver operation characteristic(SROC) curves were performed and areas under the curve were calculated.Finally,the sensitivity was analysed.Results 13 articles according to the criteria were included,in which there were seven articles about MSCTU,and two about IVP,and four both MSCTU and IVP.All groups had heterogeneity,and a random effects regression was developed.The Pooled weighted sensitivity and specificity and area under the SROC curve for MSCTU to urinary tract diseases were 0.95(0.93～0.96)/0.95(0.85～0.98)and98.88% respectively,and for IVP were 0.94(0.91～0.96)/0.61(0.57～0.65) and 68.57% respectively.Conclusion With respect to diagnostic accuracy and conclusive results,MSCTU is more accurate than IVP in the diagnosis urinary tract diseases.更多还原