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目的回顾数字射线(DR)胸片与高仟伏(Hk V)胸片对尘肺病诊断结果的文献报道,为DR胸片应用于尘肺病诊断提供科学依据。方法通过计算机检索万方、CNKI、PUBMED数据库2009—2014年有关运用DR胸片与Hk V胸片诊断尘肺病的15篇研究文献,应用meta分析对符合纳入标准的文献进行异质性检验以及合并比值比(OR合并)和95%可信区间(95%CI)的计算。采用随机效应模型分析DR胸片和Hk V胸片检查的尘肺病分期诊断结果;采用固定效应模型分析DR胸片与Hk V胸片小阴影密集度的检出。结果尘肺病各期的OR合并(95%CI)分别为:无尘肺0.98(0.79,1.21)、壹期尘肺0.97(0.77,1.22)、贰期尘肺1.21(1.01,1.45)和叁期尘肺0.90(0.67,1.19),除贰期尘肺DR胸片的敏感度略好于Hk V胸片(P<0.05)外,其他分期差异均无统计学意义。运用DR胸片与Hk V胸片判断小阴影总体密集度的meta分析结果显示,各级的OR合并(95%CI)分别为:0级0.98(0.79,1.21)、1级1.06(0.85,1.32)、2级0.96(0.71,1.28)和3级0.88(0.56,1.38),两者差异无统计学意义。结论 DR胸片可以代替Hk V胸片用作尘肺病诊断和筛查。
OBJECTIVE: To review the literature on the diagnosis of pneumoconiosis caused by digital radiography (DR) and chest X-ray (Hv V) chest radiographs, and to provide a scientific basis for the diagnosis of pneumoconiosis using DR chest radiography. Methods A total of 15 articles on the diagnosis of pneumoconiosis using DR chest radiography and Hk V chest radiographs from 2009 to 2014 were searched by Wanfang, CNKI and PUBMED databases by computer. Meta-analysis was performed on meta-analysis and inclusion Odds ratio (OR) and 95% confidence interval (95% CI). The stochastic effect model was used to analyze the staging of pneumoconiosis diagnosed by DR chest and Hk V chest radiographs. The fixed effect model was used to analyze the small shadow densities of DR chest and Hk V chest radiographs. Results The OR (95% CI) of pneumoconiosis were 0.98 (0.79, 1.21) for pneumoconiosis, 0.97 (0.77, 1.22) for pneumoconiosis in the first stage, 1.21 (1.01, 1.45 for the second stage) and 0.90 0.67, and 1.19). There was no significant difference in the staging of pneumoconiosis DR chest radiographs (P> 0.05) except for stage II pneumoconiosis DR chest radiographs. A meta-analysis of the overall intensity of small shadows using DR chest radiographs and Hk V chest radiographs showed that OR at all levels (95% CI) were 0.98 (0.79, 1.21) for grade 0, 1.06 (0.85, 1.32 ), Grade 2 0.96 (0.71,1.28) and grade 3 0.88 (0.56,1.38), the difference was not statistically significant. Conclusion DR chest radiograph can replace Hk V chest radiograph for pneumoconiosis diagnosis and screening.