中国居民颅内动脉粥样硬化性狭窄危险因素的meta分析  

A meta-analysis of risk factors of intracranial atherosclerotic stenosis in Chinese residents

作　　者：黎炳护[1] 张莉莉[1] 皮燕[1] 杨清武[1] 方传勤[1] 高长越[1] 王景周[1] 向静[1] 李敬诚[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所神经内科,重庆400042

出　　处：《中国神经精神疾病杂志》2011年第11期672-678,共7页Chinese Journal of Nervous and Mental Diseases

基　　金：国家自然基金(编号:30970998);重庆市科技攻关计划项目(编号:CSTC2010GGC502)

摘　　要：目的探讨中国大陆地区居民性别、吸烟、饮酒、高血压、糖尿病、血脂代谢异常等危险因素与颅内动脉粥样硬化性狭窄(intracranial atherosclerotic stenosis,ICAS)的关系。方法系统检索中国生物医学文献数据库、中国期刊全文数据库、MEDLINE和EMBASE数据库。综合效应分析采用RevMan 5.0.23版本软件进行meta分析。经异质性检验后对性别、吸烟、饮酒、高血压、糖尿病进行OR值的合并;血脂代谢异常(TG、TC、HDL-C、LDL-C)进行MD值的合并;绘制漏斗图和计算失安全系数判断发表偏倚;敏感性分析检验meta分析结果稳定性。结果最后9篇文献纳入meta分析,均为病例-对照研究,研究论证强度中等。性别(男性)、吸烟、饮酒、高血压、糖尿病对ICAS影响的合并OR(95%CI)值分别为1.00(0.82～1.23,P=0.99)、1.04(0.82～1.33,P=0.74)、0.91(0.69～1.20,P=0.51)、1.35(0.73～2.50,P=0.33)和1.71(1.04～2.81,P=0.03);TG、TC、HDL-C、LDL-C对ICAS影响的合并MD(95%CI)值分别为0.12(0.00～0.25,P=0.05)、0.06(-0.09～0.20,P=0.43)、-0.12(-0.23～-0.01,P=0.03)和0.24(0.14～0.33,P<0.001)。结论基于目前的研究,中国大陆地区居民糖尿病、LDL-C是ICAS的危险因素;HDL-C是ICAS的保护因素;尚无证据显示男性、吸烟、饮酒、高血压、TG、TC是ICAS的危险因素。Objective To explore the relationship between sex, cigarette smoking, alcohol consumption, hypertension, diabetes, dyslipidemia and intracranial atherosclerotic stenosis （ICAS） in China mainland residents. Methods Systematic searches of studies on association between sex, cigarette smoking, alcohol consumption, hypertension, di- abetes, dyslipidemia （total triglycerides, TG; total cholesterol, TC; high-density lipoprotein cholesterol, HDL-C; low- density lipoprotein cholesterol, LDL-C） and ICAS in China mainland residents published before December 2010 in electronic databases CBM, CNKI, MEDLINE and EMBASE were performed. Meta-analysis was carried out by software Review Manager （Version 5.0.23）. The odds ratios （ORs） of sex, cigarette smoking, alcohol consumption, hypertension, diabetes and the mean differences （MDs） of lipids level （TG, TC, HDL-C, LDL-C） were combined after heterogeneity test. Publication bias was tested by funnel plot and fail-safe number （Nfs）. Sensitivity analysis was made to assess the stability. Results A total of 9 case-control studies were identified. The combined ORs（95%Cls） of sex（male）, cigarette smoking, alcohol consumption, hypertension, diabetes were 1.00 （0.82 - 1.23, P = 0.99）, 1.04（0.82 - 1.33, P = 0.74） ; 0.91 （0.69 - 1.20, P = 0.51）, 1.35 （0.73 - 2.50, P = 0.33） and 1.71 （ 1.04 - 2.81, P = 0.03）. The combined MDs （95%Cis） ofTG, TC, HDL-C, LDL-C were 0.12（0.00 - 0.25, P= 0.05）, 0.06（-0.09 - 0.20, P= 0.43）, -0.12（-0.23 -0.01, P= 0.03） and 0.24（0.14 ~ 0.33, P〈 0.001）. Conclusions As to China mainland residents, diabetes and LDL-C are the risk factors for ICAS; HDL-C is the protective factor for ICAS; There is lack evidence that male, cigarette smoking, alcohol consumption, hypertension, TG, TC are the risk factors for ICAS.

关 键 词：颅内狭窄 动脉粥样硬化危险因素 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]