动脉粥样硬化性肾动脉狭窄传统危险因素的Meta分析  

Traditional risk factors of atherosclerotic renal artery stenosis:a meta-analysis

作　　者：刘波[1] 吕建峰[1] 粟治洲 王刚[1] 任梦宇 周亮[2] 迟路湘[1] 

机构地区：[1]第三军医大学西南医院心血管内科重庆市介入心脏病学研究所,重庆400038 [2]第三军医大学军事预防医学院卫生统计学教研室,重庆400038

出　　处：《第三军医大学学报》2014年第19期2037-2043,共7页Journal of Third Military Medical University

摘　　要：目的系统评价动脉粥样硬化性肾动脉狭窄(atherosclerotic renal artery stenosis,ARAS)的传统危险因素间危险强度的差异。方法通过计算机文献检索PubMed、EMBASE、Cochrane图书馆、Web of science、CNKI、万方数据库、VIP、CBM,检索自建库至2013年10月发表的所有关于动脉粥样硬化性肾动脉狭窄危险因素的病例对照研究,由2名研究者通过双人独立评审的方式按照排除标准进行筛选文献并提取资料,采用RevMan 5.2统计软件进行Meta分析。结果共纳入17篇文献,显示女性、高血压、血脂异常、糖尿病、冠状动脉左主干病变与ARAS有关,其OR(95%CI)分别为1.31(1.21,1.42)、2.42(2.18,2.67)、1.55(1.18,2.05)、1.44(1.31,1.58)、1.86(1.46,2.37),收缩压与ARAS有关,其SMD(95%CI)值为11.08(5.01,17.16);而舒张压则与ARAS关系不大,舒张压SMD(95%CI)为1.46(-3.19,6.10)。结论女性、高血压、血脂异常、糖尿病、冠状动脉左主干病变、收缩压是动脉粥样硬化性肾动脉狭窄的危险因素,还不能认为舒张压对ARAS的发病有影响。Objective To systematically evaluate the differences of the danger intensity among traditional risk factors for atherosclerotic renal artery stenosis （ARAS）. Methods We gathered all casecontrol studies about risk factors for ARAS in the following databases： PubMed, EMBASE, The Cochrane library, CNKI, Wanfang, VIP, CBM until October 14, 2013. According to exclude standards, 2 reviewers extracted all relevant data from the screened documents independently, and then the extracted date were analyzed by using RevMan 5.2 software. Results Seventeen trials were included in the meta-analysis. Metaanalysis showed that ： female, hypertension, dyslipidemia, diabetes and the disease of left main coronary artery had relationship with ARAS. Their pooled OR and 95% CI were 1.31 （ 1.21, 1.42）, 2.42 （2.18, 2.67）, 1.55 （ 1.18, 2.05） , 1.44 （ 1.31, 1.58）, and 1.86 （ 1.42, 2.37） respectively. Systolic blood pressure also had relationship with ARAS, its SMD＇ s 95% CI was 11.08 （5.01, 17. 16）. But diastolic blood pressure seemed to have litt]e relationship with ARAS, with its SMD＇s 95% CI of 1.46 （ -3.19, 6.10）. Conclusion Traditional factors like female, hypertension, dyslipidemia, diabetes, the disease of left main coronary artery and systolic blood pressure are risk factors for ARAS, but diastolic blood pressure have not be considered to having an effect on the incidence of ARAS.

关 键 词：动脉粥样硬化 肾动脉狭窄 危险因素 病例对照研究 

分 类 号：R181.23[医药卫生—流行病学] R543.5[医药卫生—公共卫生与预防医学]