CT扫描与静脉肾盂造影检查诊断肾结核的Meta分析

摘要

Objective To evaluate the value of CT scanning and versus intravenous pyelography ( IVP) in diagnosing renal tuberculosis in China. Methods We conducted Meta-analysis on records published during January 1994 and November 2011 with sofeware Slata 11.0 about diagnosed renal tuberculosis by CT scanning and IVP in China. The odd ration (OR) and 95% confidence interval (95% CI) of the combination effect value was counted after heterogeneity test. Publication bias was tested by Beggs regression funnel plot and Eggers test. Sensitivity analysis was made. Results 8 records for indexes included 483 Chinese cases. All the patients underwent CT scanning and IVP, respectively. The combined OR and 95% CI of the diagnostic rate of the renal tuberculosis was 5.24, (1.74, 15.81), P =0.003. There was no publication bias by Beggs funnel plot and Eggers regression test that we had choosen. The Meta-analysis results using sensitivity analysis was reliable. Conclusion The existing clinical evidence shows that the diagnostic value of CT scanning is obviously superior to IVP as a preferred clinical iconography examination in the diagnosis of renal tuberculosis.%目的 探讨CT扫描与静脉肾盂造影(intravenous pyelography,IVP)检查对我国人群肾结核的诊断价值.方法 运用Stata11.0统计软件对1994年1月～2011年11月有关我国人群使用CT扫描与IVP检查诊断肾结核的文献进行Meta分析,在进行异质性检验后计算合并效应值优势比(odds ratio,OR)及95％可信区间(95％ confidence interval,95％CI)；采用Begg漏斗图法和Egger回归法判断发表偏倚,最后进行敏感性分析.结果 检索并纳入文献共8篇483例,CT扫描与IVP检查对肾结核诊断率的合并OR=5.24,95％CI(1.74,15.81),P=0.003.Begg漏斗图法和Egger回归法检验显示本文所选以上两种影像学检查方法对肾结核诊断率的研究不存在发表偏倚.敏感性分析结果显示本次Meta分析结果可靠.结论 基于目前的研究发现,CT扫描对肾结核的诊断价值明显优于IVP检查,可作为诊断肾结核的首选影像学检查方法.