摘要
目的评价国内外超声心动图(UCG)与心电图(ECG)对高血压性心脏病的诊断准确率。方法检索从建库至2020年2月Pubmed、EMbase、Cochrane library、CNKI、VIP和万方医学数据库,筛选有关UCG与ECG对高血压性心脏病诊断准确率的文献,提取基本资料和左房增大、左室肥厚、ST-T改变、主动脉弹性退缩、主动脉扩张和心律失常等相关参数,采用Revman5.3软件进行Meta分析,比较两种方法对高血压性心脏病的诊断准确率。结果共纳入21篇文献,累积1966例。Meta分析结果显示,UCG对高血压性心脏病的确诊率明显高于ECG[RR=1.26,95%CI(1.22,1.29),P<0.00001],差异有统计学意义;两种方法对左房增大[RR=1.51,95%CI(1.28,1.78),P<0.00001、左室肥厚RR=1.60,95%CI(1.37,1.87),P<0.00001]、主动脉弹性退缩[RR=13.22,95%CI(5.10,34.29),P<0.00001、主动脉扩张RR=19.20,95%CI(5.17,71.28),P<0.0001]的检出率比较差异均具有统计学意义;但两种方法在ST-T改变[RR=0.78,95%CI(0.55,1.11),P=0.17]和心律失常[RR=0.99,95%CI(0.60,1.65),P=0.98]方面的检出率比较差异均无统计学意义。结论UCG对高血压性心脏病的诊断准确率明显优于ECG,对早诊断、早治疗及改善预后具有重大意义。
Objective To evaluate the accuracy of echocardiography and electrocardiogram in the diagnosis of hypertensive heart disease.Methods Pubmed,EMbase,Cochrane library,CNKI,VIP,and Wanfang medical Database were searched through February 2020 for literatures on the diagnostic accuracy of echocardiography and electrocardiogram for hypertensive heart disease.The basic data,left atrial enlargement,left ventricular hypertrophy,ST-T change,aortic elastic shrinkage,aortic dilatation,arrhythmia,was extracted.Meta-analysis was performed using Revman 5.3 software to compare the diagnostic accuracy of the two methods in hypertensive heart disease.Results A total of 21 studies(involving 1966 patients)were included.The results of meta-analysis showed that:compared with electrocardiogram,echocardiography was more accurate in diagnosing hypertensive heart disease(RR=1.26,95%CI 1.22,1.29,P<0.00001).The diagnostic rate of left atrial enlargement(RR=1.51,95%CI 1.28,1.78,P<0.00001),diagnosis of left ventricular hypertrophy(RR=1.60,95%CI 1.37,1.87,P<0.00001),diagnosis of aortic elastic shrinkage(RR=13.22,95%CI 5.10,34.29,P<0.00001),diagnosis of aortic dilatation(RR=19.20,95%CI 5.17,71.28,P<0.0001).However,there were no statistically significant differences in the diagnosis of ST-T change(RR=0.78,95%CI 0.55,1.11,P=0.17)and arrhythmia(RR=0.99,95%CI 0.60,1.65),P=0.98)between two groups.Conclusion Available evidence suggests that from the perspective of diagnostic accuracy,echocardiography is better than electrocardiogram in diagnosing hypertensive heart disease,which is of great significance for early diagnosis,shortening of treatment time,and improving prognosis.
作者
陈悦
刘蓉
董芝芝
赵秋霞
CHEN Yue;LIU Rong;DONG Zhi-zhi;ZHAO Qiu-xia(Department of Ultrasound,the First College of Clinical Medical Science,China Three Gorges University&Yichang Central People's Hospital,Yichang 443000,Hubei,CHINA)
出处
《海南医学》
CAS
2021年第3期387-393,共7页
Hainan Medical Journal
基金
湖北省宜昌市医疗卫生科研项目(编号:A17-301-06)。
关键词
超声心动图
心电图
高血压性心脏病
诊断准确率
META分析
Echocardiography
Electrocardiography
Hypertensive heart disease
Diagnosis accuracy
Meta-analysis
