运动平板试验与冠状动脉CTA诊断冠状动脉粥样硬化性心脏病的Meta分析

目的比较运动平板试验(TET)和冠状动脉CTA(CCTA)对冠状动脉粥样硬化性心脏病的诊断价值。方法检索Pubmed、Embase、Cochrane Library、Web of Science、万方、维普、中国知网及中国生物医学数据库,筛选文献,评估文献质量,提取数据进行分析。分别对采用TET和CCTA检查的研究数据加权定量合并,计算汇总敏感度、特异度及其95%可信区间(95%CI)。绘制ROC曲线,计算并比较曲线下面积。结果最终纳入15篇文献(1 976例患者);CCTA和TET的汇总敏感度分别为0.93(95%CI 0.89~0.95)、0.65(95%CI 0.58~0.71),汇总特异度分别为0.86(95%CI 0.76~0.92)、0.58(95%CI 0.47~0.69),ROC曲线下面积分别为0.96(95%CI 0.93~0.97)、0.66(95%CI 0.62~0.70)。结论TET对于冠状动脉粥样硬化性心脏病的诊断效能低于CCTA。

Treadmill exercise test versus coronary computed tomography angiography in diagnosis of coronary atherosclerotic heart disease: Meta-analysis

Objective To compare the value of treadmill exercise test (TET) versus coronary computed tomography angiography (CCTA) in the diagnosis of coronary atherosclerotic heart disease. Methods Studies corresponding with assigned inclusion criteria were recruited by systematically searching in the databases of Pubmed, Embase, Cochrane Library, Web of Science, Wanfang, Vip, CNKI and CBM. The methodological quality of included studies was assessed followed by data extraction and statistical analysis. The data of TET or CCTA in the included studies were combined statistically to calculate the total sensitivity, specificity and 95% confidence interval (95%CI). The ROC curve for TET and CCTA was generated, then the areas under the curve (AUC) were calculated and compared. Results A total of fifteen studies involving 1 976 patients were included. The total sensitivity of the CCTA and TET was 0.93 (95%CI 0.89-0.95) and 0.65 (95% CI 0.58-0.71), the total specificity of them was 0.86 (95% CI 0.76-0.92) and 0.58 (95% CI 0.47-0.69), and their AUC was 0.96 (95% CI 0.93-0.97) and 0.66 (95% CI 0.62-0.70), respectively. Conclusion TET has a lower diagnostic efficiency compared to CCTA for the diagnosis of coronary atherosclerotic heart diseases.