PDF(Pubmed)
Abstract：
OBJECTIVE: To evaluate the accuracy of different parameters of the ophthalmic artery Doppler (OAD) in the complementary diagnosis of preeclampsia (PE).
METHODS: This meta-analysis adhered to the PRISMA guidelines. To investigate the mean difference in OAD values, peak systolic velocity (PSV), end-diastolic velocity (EDV), second systolic velocity peak (P2), resistance index (RI), pulsatility index (PI), and peak ratio (PR), between PE cases (overall and according to severity) and controls, random-effects meta-analyses were conducted for each Doppler parameter, with overall PE and mild and severe PE subgroups. Diagnostic performance and heterogeneity were evaluated with summary receiver operating characteristic (sROC) curves and 95% confidence intervals obtained with bivariate models.
RESULTS: Eight studies stratified the results into mild and severe or late and early PE, involving 1,425 pregnant women. PR and P2 had better diagnostic performance than the other indexes, with the PR of AUsROC at 0.885, the sensitivity of 84%, and specificity of 92%, with a low false-positive rate of 0.08 and the P2 with AUsROC of 0.926, the sensitivity of 85% and specificity of 88%. RI, PI, and EDV showed good performance and consistency across studies but lower AUsROC values of 0.833, 0.794, and 0.772, respectively.
CONCLUSIONS: Ophthalmic artery Doppler is a complementary tool with good performance for the diagnosis of overall and severe preeclampsia, with high and best sensitivity and specificity when using PR and P2 parameters.
METHODS: This meta-analysis adhered to the PRISMA guidelines. To investigate the mean difference in OAD values, peak systolic velocity (PSV), end-diastolic velocity (EDV), second systolic velocity peak (P2), resistance index (RI), pulsatility index (PI), and peak ratio (PR), between PE cases (overall and according to severity) and controls, random-effects meta-analyses were conducted for each Doppler parameter, with overall PE and mild and severe PE subgroups. Diagnostic performance and heterogeneity were evaluated with summary receiver operating characteristic (sROC) curves and 95% confidence intervals obtained with bivariate models.
RESULTS: Eight studies stratified the results into mild and severe or late and early PE, involving 1,425 pregnant women. PR and P2 had better diagnostic performance than the other indexes, with the PR of AUsROC at 0.885, the sensitivity of 84%, and specificity of 92%, with a low false-positive rate of 0.08 and the P2 with AUsROC of 0.926, the sensitivity of 85% and specificity of 88%. RI, PI, and EDV showed good performance and consistency across studies but lower AUsROC values of 0.833, 0.794, and 0.772, respectively.
CONCLUSIONS: Ophthalmic artery Doppler is a complementary tool with good performance for the diagnosis of overall and severe preeclampsia, with high and best sensitivity and specificity when using PR and P2 parameters.
摘要：
目的：评估眼动脉多普勒（OAD）不同参数在子痫前期（PE）补充诊断中的准确性。
方法：本荟萃分析遵循PRISMA指南。为了调查OAD值的平均差，收缩期峰值速度(PSV),舒张末期血流速度(EDV),第二收缩期速度峰值（P2），阻力指数(RI)，搏动指数(PI),和峰比(PR)，在PE病例（总体和根据严重程度）和对照之间，对每个多普勒参数进行随机效应荟萃分析，总体PE和轻度和重度PE亚组。通过双变量模型获得的受试者工作特征（sROC）曲线和95％置信区间来评估诊断性能和异质性。
结果：8项研究将结果分为轻度和重度或晚期和早期PE，涉及1,425名孕妇。PR和P2的诊断性能优于其他指标，AUsROC的PR为0.885，灵敏度为84%，和92%的特异性，具有低的假阳性率0.08和P2的AUsROC为0.926,敏感性为85%,特异性为88%。RI,PI,和EDV在研究中显示出良好的性能和一致性，但AUsROC值分别为0.833、0.794和0.772。
结论：眼动脉多普勒是诊断整体和重度先兆子痫的良好辅助工具，使用PR和P2参数时具有较高且最佳的灵敏度和特异性。
方法：本荟萃分析遵循PRISMA指南。为了调查OAD值的平均差，收缩期峰值速度(PSV),舒张末期血流速度(EDV),第二收缩期速度峰值（P2），阻力指数(RI)，搏动指数(PI),和峰比(PR)，在PE病例（总体和根据严重程度）和对照之间，对每个多普勒参数进行随机效应荟萃分析，总体PE和轻度和重度PE亚组。通过双变量模型获得的受试者工作特征（sROC）曲线和95％置信区间来评估诊断性能和异质性。
结果：8项研究将结果分为轻度和重度或晚期和早期PE，涉及1,425名孕妇。PR和P2的诊断性能优于其他指标，AUsROC的PR为0.885，灵敏度为84%，和92%的特异性，具有低的假阳性率0.08和P2的AUsROC为0.926,敏感性为85%,特异性为88%。RI,PI,和EDV在研究中显示出良好的性能和一致性，但AUsROC值分别为0.833、0.794和0.772。
结论：眼动脉多普勒是诊断整体和重度先兆子痫的良好辅助工具，使用PR和P2参数时具有较高且最佳的灵敏度和特异性。
