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Abstract：
The role of postnatal Doppler measurements of the superior mesenteric artery (SMA) in detecting neonates at risk of necrotizing enterocolitis (NEC) remains uncertain; therefore, we systematically reviewed and meta-analyzed the existing evidence regarding the usefulness of SMA Doppler measurements in detecting neonates at risk for NEC. We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, and we included studies which reported the following Doppler ultrasonography indices: peak systolic velocity, end-diastolic velocity, time average mean velocity, differential velocity, pulsatility index (PI) and resistive index. Eight studies were eligible for inclusion in the meta-analysis. Evidence suggested that, during the first postnatal day, neonates who developed NEC had a significantly higher peak systolic velocity (mean difference of 2.65 cm/s (95% confidence interval [CI] 1.23, 4.06, overall effect Z=3.66, P<0.001)), higher PI (mean difference of 1.52 (95% CI 0.00, 3.04, Z=1.96, P=0.05)) and higher resistive index (mean difference of 1.09 (95% CI 0.59, 1.60, Z=4.24, P<0.001)), compared to neonates who did not develop NEC. However, our findings do not support a strong association between the Doppler ultrasound indices and development of NEC at the time of disease onset. This meta-analysis suggests that first postnatal day SMA Doppler parameters, namely peak systolic velocity, PI and resistive index, are higher in neonates who develop NEC. On the other hand, the aforementioned indices are of uncertain significance once the diagnosis of NEC has been established.
摘要：
出生后多普勒测量肠系膜上动脉（SMA）在检测有坏死性小肠结肠炎（NEC）风险的新生儿中的作用仍不确定；因此，我们系统回顾并荟萃分析了有关SMA多普勒测量在检测有NEC风险的新生儿方面有用性的现有证据.我们使用系统评价和荟萃分析指南的首选报告项目，我们纳入了报道以下多普勒超声检查指标的研究：峰值收缩期速度，舒张末期血流速度,时间平均平均速度，差速,脉动指数(PI)和电阻指数。有8项研究符合纳入荟萃分析的条件。证据表明,在产后第一天，发生NEC的新生儿收缩压峰值速度明显较高（平均差为2.65cm/s（95％置信区间[CI]1.23，4.06，总体效应Z=3.66，P<0.001）），较高的PI（平均差异为1.52（95％CI0.00，3.04，Z=1.96，P=0.05））和较高的电阻指数（平均差异为1.09（95％CI0.59，1.60，Z=4.24，P<0.001）），与未发生NEC的新生儿相比。然而,我们的研究结果不支持多普勒超声指数与疾病发作时NEC的发展之间有很强的相关性.这项荟萃分析表明，出生后第一天SMA多普勒参数，即收缩期峰值速度，PI和电阻指数，在发展NEC的新生儿中更高。另一方面,一旦确定了NEC的诊断,上述指标具有不确定的意义.
