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中华重症医学电子杂志 ›› 2019, Vol. 05 ›› Issue (03) : 243 -248. doi: 10.3877/cma.j.issn.2096-1537.2019.03.008

所属专题: 文献

重症医学研究

综合脱机指数预测机械通气脱机价值的Meta分析
张斌1, 曹薇1, 吴秀1, 刘运安1, 赵媛1, 张青青1, 王胜昱1,()   
  1. 1. 710077 西安,西安医学院第一附属医院呼吸与危重症医学科
  • 收稿日期:2018-12-03 出版日期:2019-08-28
  • 通信作者: 王胜昱
  • 基金资助:
    陕西省重点研发计划基金(2017SF-256); 陕西省呼吸病预防与诊治工程研究中心开放基金(2016HXKF09)

Diagnosis accuracy of integrative weaning index for weaning from mechanical ventilation: A Meta-analysis

Bin Zhang1, Wei Cao1, Xiu Wu1, Yun′an Liu1, Yuan Zhao1, Qingqing Zhang1, Shengyu Wang1,()   

  1. 1. Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Xi′an Medical University, Xi′an 710077, China
  • Received:2018-12-03 Published:2019-08-28
  • Corresponding author: Shengyu Wang
  • About author:
    Corresponding author: Wang Shengyu, Email:
引用本文:

张斌, 曹薇, 吴秀, 刘运安, 赵媛, 张青青, 王胜昱. 综合脱机指数预测机械通气脱机价值的Meta分析[J/OL]. 中华重症医学电子杂志, 2019, 05(03): 243-248.

Bin Zhang, Wei Cao, Xiu Wu, Yun′an Liu, Yuan Zhao, Qingqing Zhang, Shengyu Wang. Diagnosis accuracy of integrative weaning index for weaning from mechanical ventilation: A Meta-analysis[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2019, 05(03): 243-248.

目的

采用Meta分析系统评价综合脱机指数(IWI)对机械通气脱机的诊断价值。

方法

系统检索PubMed、Web of Science、EMbase、中国知网、万方等数据库,检索时间为各数据库建库至2018年10月。由2人按照设定的纳入与排除标准进行筛选文献,查找相关文献,并采用QUADAS-2对纳入文献进行质量评价,利用Meta-DiSc软件进行数据分析、汇总结果。

结果

共纳入5篇文献和783例患者,IWI对有创机械通气脱机的合并诊断价值如下:敏感度为0.95(95%CI:0.90~0.99),特异度为0.81(95%CI:0.68~0.94),阳性似然比为4.46(95%CI:1.98~10.07),阴性似然比为0.08(95%CI:0.03~0.19),诊断比值比为60.34(95%CI:16.54~220.05),综合受试者曲线下面积为0.9466。

结论

IWI在有创机械通气脱机的诊断中具有一定的诊断价值,可作为辅助预测脱机的诊断指标。

Objective

To investigate the value of integrative weaning index (IWI) on weaning from mechanical ventilation.

Methods

The PubMed, Web of Science, EMbase, CNKI, WangFang Databases were searched for IWI diagnostic accuracy on weaning from mechanical ventilation up to October 2018. Two reviewers independently screened the literatures based on the inclusion and exclusion criteria. The methodological quality of included studies was assessed by QUADAS-2. Data were analyzed by Meta-DiSc software.

Results

Five studies involving 783 patients were included. The summary estimates for IWI diagnostic accuracy on weaning from mechanical ventilation included: sensitivity 0.95 (95%CI: 0.90-0.99), specificity 0.81 (95%CI: 0.68-0.94), positive likelihood ratio 4.46 (95%CI: 1.98~10.07), negative likelihood ratio 0.08 (95%CI: 0.03-0.19), diagnosis odds ratio 60.34 (95%CI: 16.54-220.05), and the area under the curve of SROC was 0.9466.

Conclusion

IWI can improve the diagnostic accuracy on weaning from mechanical ventilation.

图1 纳入文献筛选流程图
表1 纳入IWI预测机械通气脱机拔管的研究
表2 纳入文献的基本特征
图2 纳入研究的整体治疗评估
图3 各项研究的偏差风险
图4 纳入研究的诊断效能。图a、b、c、d、e分别为IWI预测脱机拔管的敏感度、特异度、PLR、NLR、DOR森林图
图5 IWI预测脱机拔管的SROC曲线图
表3 纳入文献亚组分析结局指标
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