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目的:系统评价血管外肺水(extravascular lung water, EVLW)判断危重患者预后的诊断准确性。方法检索Pubmed、Embase、中国学术期刊全文数据库(CNKI)、重庆维普中文科技期刊全文数据库(VIP)和万方数据库等数据库,筛选血管外肺水与危重患者预后的相关文献,使用QUIPS(Quality In Prognosis Studies)质量评价量表评价纳入文献的偏移风险,2名研究人员独立筛选、评价文献和收集数据,采用Revman5.3和Metadisc1.4进行统计学分析。结果共纳入12篇符合入选标准文献,纳入研究样本量均不大,共572例研究对象,分布在我国8个省份的ICU病房,数据合并结果提示死亡组血管外肺水明显高于存活组(MD=5.54,95%CI:4.75~6.32),EVLW判断危重患者预后诊断准确性合并数据:敏感性84%(79%~88%);特异性73%(68%~78%);阳性似然比2.92(2.24~3.80);阴性似然比0.24(0.18~0.32);sROC曲线下面积0.8749。结论 EVLW是危重患者预后不佳的危险因素,可以较好的判断危重患者的预后。“,”Objectives To systematically review the literature evaluating the prognostic value of extravascular lung water (EVLW). Methods Two independent reviewers performed systematic searches of Pubmed, Embase, CNKI, WanFang Data and VIP to identify potentially relevant studies investigating the prognostic value of EVLW in critically ill patients. A pooled-analysis was conducted by adopting Revman 5.3 and Metadisc1.4. Results A total of 572 cases which were collected from 8 provinces were consisted of the 12 papers. Overall, the EVLWI was significantly higher in non-survival group than the survival group with a mean difference of 5.54mL/kg (95% confidence interval, 4.75 to 6.32). The pooled statistics of diagnostic accuracy together with relevant 95%confidence interval reflected as follows:sensitivity, 84% (79%~88%); specificity, 73% (68%~78%); positive LR 2.92 (2.24~3.80); negative LR 0.24 (0.18~0.32);sROC 0.8749. Conclusion The EVLW may serve as valid indicator of mortality in critically ill patients.