肺部超声检测COVID-19的诊断价值：系统综述和荟萃分析

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论证：在评估COVID-19患者病情的严重程度时，主要依赖肺组织损伤的体积。有许多诊断方法允许分析该指标，每一种方法都有一定的局限性。研究的目的和设计，观察患者的特点，设备的可用性，所有这些参数都可以影响最佳方法的选择。

目的是通过对PubMed和Google Scholar数据库中相关英文文章的系统回顾，评估超声作为一种分析COVID-19患者肺损伤程度的方法的敏感性和特异性。关键词：lung ultrasound; chest ultrasound; thoracic ultrasound; ultrasonography; COVID-19; SARS-CoV-2; coronavirus; diagnosis; diagnostic value; specificity; sensitivity该综述仅包括了针对疑似COVID-19患者肺部超声诊断准确性问题的研究。参考方法包括胸部CT、逆转录聚合酶链反应检测病毒RNA、实验室数据等。论文由两位作者独立抽取，填写标准化表格的指定字段，然后对研究质量指标进行评价。为了分析和分组所选研究中肺超声评估肺组织改变体积的敏感性和特异性的数据，使用了随机效应模型。根据规定的纳入标准，适合16项研究，但仅对3例患者根据疾病严重程度划分明确组。通过其他有关材料，为了评估次要结果，使用了肺部超声诊断COVID-19的敏感性和特异性值，而不考虑患者的病情。当研究根据筛查、疾病严重程度评估和患者队列进行分组时，观察到的主要结果和次要结果的异质性得以保持。肺部超声诊断重症冠状病毒感染COVID-19患者肺损害的准确性最高（敏感性为87.6±12.3%，特异性为80.5±7.1%）。同时，该方法在轻度疾病患者中的准确率最低（敏感性为72.8±7.1%，特异性为74.3±2.7%）。

结果。肺部超声检查可用于确诊COVID-19的患者，以检测肺组织的严重损害。该方法评估轻微-中度肺损伤的诊断价值相对较低。

 

作者简介

Natalia Vetsheva

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department; Moscows regional research clinical institute n.a. M.F. Vladimirskiy

编辑信件的主要联系方式.
Email: vetsheva@npcmr.ru
ORCID iD: 0000-0002-9017-9432
SPIN 代码: 9201-6146

MD, PhD

俄罗斯联邦, Moscow

Roman Reshetnikov

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department; Sechenov First Moscow State Medical University (Sechenov University)

Email: reshetnikov@fbb.msu.ru
ORCID iD: 0000-0002-9661-0254
SPIN 代码: 8592-0558

PhD

俄罗斯联邦, Moscow

Denis Leonov

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department

Email: d.leonov@npcmr.ru
ORCID iD: 0000-0003-0916-6552
SPIN 代码: 5510-4075

PhD

俄罗斯联邦, Moscow

Nikolas Kulberg

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department

Email: kulberg@npcmr.ru
ORCID iD: 0000-0001-7046-7157
SPIN 代码: 2135-9543

PhD

俄罗斯联邦, Moscow

Olesya Mokienko

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Care Department

Email: o.mokienko@npcmr.ru
ORCID iD: 0000-0002-7826-5135
SPIN 代码: 8088-9921

MD, PhD

俄罗斯联邦, Moscow

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1. JATS XML
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2. 图 1研究选择图表。

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3. 图 2被纳入研究的研究的地理位置。 注：世界地图的图像是在Shutterstock资源上购买的，之后进行更改[35]。

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4. 图 3.16项研究的系统误差风险直方图。

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5. 图 4按特异性（A）和敏感性（B）分组数据的森林图*和**符号表示M. Yassa等人的研究，分别致力于不同专家结论的一致性[25]和超声在COVID-19筛查中的诊断意义[26]。SMD—标准均数差；CI—置信区间。

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版权所有 © Vetsheva N., Reshetnikov R., Leonov D., Kulberg N., Mokienko O., 2020

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