不同程度认知障碍与老年患者抑郁症相关性研究  

Correlation of different severity of cognitive impairment and geriatric depression

作　　者：曾令烽[1,2] 梁伟雄[2] 曹烨[3] 邹元平[4] 王璐[5] 许卫华[1] 孔令朔 王奇[1,2] 王宁生[1,4] 

机构地区：[1]广州中医药大学临床药理研究所,广州510405 [2]广东省中医院,广州510120 [3]中山大学附属肿瘤医院,广州510120 [4]广州中医药大学,广州510405 [5]世界中医药学会联合会,北京100101

出　　处：《中华中医药杂志》2016年第5期1906-1913,共8页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金资助项目(N o.81473740);创新工程-省级优博培育项目(N o.A1-AFD015141Z10504);华南中医药协同创新中心-中医药防治脑病及脾胃病创新研究团队项目(No.A1-AFD01514A05);广州中医药大学中医内科学特色重点学科建设经费(No.2013-2015)~~

摘　　要：目的:系统评价痴呆、非痴呆征象轻度认知障碍(MCINS)等不同程度认知障碍对老年期抑郁(GD)发病的关联性影响。方法:全面搜集与GD发病危险因素相关的研究文献,计算机综合检索万方数据库、中国知网、维普数据库及中国生物医学文献数据库、Pub Med、EMbase、MEDLINE与Cochrane Library,检索时间止于2015年10月25日;同时在广州中医药大学图书馆手工检索期刊资料库。所有涉及认知功能与GD发病相关性、可提取有效数据的研究文献均纳入作分析。纳入研究分为横剖研究和纵贯研究,并采用Cochrane推荐软件Rev Man5.3对结果进行Meta分析,对GD患病率和发病率分别计算其关联强度比值比(OR)值、相对危险度(RR)值及95%可信区间(CI),作相应的发表偏倚、异质性检验及基于不同程度认知障碍文献的亚组分析。结果:本研究共纳入24个研究文献,其中横剖研究15个,前瞻性纵贯研究9个,共45 861例患者,Meta分析提示:在老年人群中,痴呆患者无论在GD患病率(OR=2.18,95%CI[1.54,3.10])还是发病率(RR=3.44,95%CI[1.95,6.05])方面比较,均高于无痴呆患者;然而MCINS患者其GD患病率(OR=1.39,95%CI[0.92,2.09])、发病率(RR=1.30,95%CI[0.93,1.82])与无MCINS患者比较,差异均无统计学意义。结论:痴呆可增加GD的发病风险;轻度认知障碍且无痴呆征象的患者,其与GD发病并不存有相关性。Objective： To systematically evaluate whether different severity of cognitive impairment including dementia and mild cognitive impairment（MCINS） to increase the incidence of geriatric depression（GD）. Methods： Potential studies involving risk factors for GD were searched from WANFANG, CNKI, VIP, CBM, Pub Med, EMbase, MEDLINE and the Cochrane Library database, with setting a deadline of October 25, 2015. At the same time, the literatures involving the theme were also manually retrieved from the journals in college library. The studies that reporting data for the correlation of cognitive impairment and risks of GD（with ages≥65） were brought into for analysis. The studies included cross-sectional studies and longitudinal studies. The data were processed with meta analysis by the software Rev Man 5.3 recommended by Cochrane. The odds risk（OR）, relative risk（RR） and 95% confidence intervals（CI） were respectively calculated in the terms of the prevalence rate and incidence rate of GD. The publication bias, heterogeneity test, and subgroup analysis based on different severity of cognitive impairment were conducted on the basis of the inclusive literature. Results： A total of 24 literatures were included in the research, among of which involved in 15 cross-sectional studies and 9 longitudinal studies. The results of meta analysis indicated that both of the prevalence rate（OR=2.18, 95%CI [1.54, 3.10]） and incidence rate（RR=3.44, 95%CI [1.95, 6.05]） in patients with dementia were higher than those in patients with MCINS. There were no significant differences in the prevalence rate（OR=1.39, 95%CI [0.92, 2.09]） and incidence rate（RR=1.30, 95%CI [0.93, 1.82]） between the non MCINS patients and MCINS patients. Conclusion： There was definite correlation between dementia and GD, and dementia could be a risk factor for the incidence of GD. The patients with MCINS were not associated with the incidence of GD. However, due to the limitations of methodological quality among the includ

关 键 词：痴呆 认知障碍 老年期抑郁 发病风险 META分析 

分 类 号：R749.4[医药卫生—神经病学与精神病学] R749.1[医药卫生—临床医学]