标题：超声心动图与心电图诊断高血压性心脏病的Meta分析

      作者：陈悦，刘蓉，董芝芝，赵秋霞    三峡大学第一临床医学院&宜昌市中心人民医院超声科，湖北 宜昌 443000

      卷次： 2021年32卷3期

      【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1 966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<0.000 01]，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<0.000 01、左室肥厚 RR=1.60，95%CI (1.37，1.87)，P<0.000 01]、主动脉弹性退缩[RR=13.22，95%CI (5.10，34.29)，P<0.000 01、主动脉扩张 RR=19.20，95%CI (5.17，71.28)，P<0.000 1]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。
      【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
      【中图分类号】 R544.1 【文献标识码】 A 【文章编号】 1003—6350（2021）03—0387—07

Accuracy of echocardiography and electrocardiogram in the diagnosis of hypertensive heart disease: ameta-analysis.
CHEN Yue, LIU Rong, DONG Zhi-zhi, ZHAO Qiu-xia. Department of Ultrasound, the First College ofClinical Medical Science, China Three Gorges University & Yichang Central People's Hospital, Yichang 443000, Hubei,CHINA
【Abstract】 Objective To evaluate the accuracy of echocardiography and electrocardiogram in the diagnosis ofhypertensive heart disease. Methods Pubmed, EMbase, Cochrane library, CNKI, VIP, and Wanfang medical Databasewere searched through February 2020 for literatures on the diagnostic accuracy of echocardiography and electrocardio-gram 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 soft-ware to compare the diagnostic accuracy of the two methods in hypertensive heart disease. Results A total of 21 stud-ies (involving 1 966 patients) were included. The results of meta-analysis showed that: compared with electrocardio-gram, echocardiography was more accurate in diagnosing hypertensive heart disease (RR=1.26, 95%CI 1.22, 1.29, P<0.000 01). The diagnostic rate of left atrial enlargement (RR=1.51, 95%CI 1.28, 1.78, P<0.000 01), diagnosis of left ven-tricular hypertrophy (RR=1.60, 95%CI 1.37, 1.87, P<0.000 01), diagnosis of aortic elastic shrinkage (RR=13.22, 95%CI5.10, 34.29, P<0.000 01), diagnosis of aortic dilatation (RR =19.20, 95%CI 5.17,71.28, P<0.000 1). However, there wereno statistically significant differences in the diagnosis of ST-T change (RR=0.78, 95%CI 0.55, 1.11, P=0.17) and arrhyth-mia (RR=0.99, 95%CI 0.60,1.65), P=0.98) between two groups. Conclusion Available evidence suggests that from theperspective of diagnostic accuracy, echocardiography is better than electrocardiogram in diagnosing hypertensive heart dis-ease, which is of great significance for early diagnosis, shortening of treatment time, and improving prognosis.
      【Key words】 Echocardiography; Electrocardiography; Hypertensive heart disease; Diagnosis accuracy; Me-ta-analysis·荟萃分析·doi:10.3969/j.issn.1003-6350.2021.03.030基金项目：湖北省宜昌市医疗卫生科研项目(编号：A17-301-06)