高氧血症对成年心脏骤停患者院内死亡率及出院后1年内神经系统影响的Meta分析  

Impact of Hyperoxia on Hospital Mortality and Nervous System 1-year after Discharge in Adult Patients with Sudden Cardiac Arrest:a Meta-analysis

作　　者：谢勇[1] 高登峰[2] XIE Yong;GAO Deng-feng(Department of Emergency,West China Hospital of Sichuan University,Sichuan 610041,China;Department of Cardiology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]四川大学华西医院急诊科,四川省成都市610041 [2]西安交通大学第二附属医院心内科,陕西省西安市710004

出　　处：《实用心脑肺血管病杂志》2018年第6期1-4,9,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：国家自然科学基金资助项目(81570382)

摘　　要：目的评价高氧血症对成年心脏骤停患者院内死亡率及出院后1年内神经系统的影响。方法计算机检索PubMed、EMBase及Cochrane临床对照研究中心注册数据库,筛选有关高氧治疗与成年心脏骤停患者院内死亡率及出院后1年内神经系统关系的研究。根据治疗后动脉血氧分压(PaO_2)分为高氧血症组与正常氧浓度组,比较两组患者院内死亡率及出院后1年内神经系统恢复不良发生率;采用Review Manager v5.14软件进行Meta分析。结果共纳入12篇英文文献,其中3篇为前瞻性队列研究,包括9 643例患者;9篇为回顾性研究,包括26 165例患者。Meta分析结果显示,高氧血症组患者院内死亡率高于正常氧浓度组[OR=1.38,95%CI(1.15,1.66),P=0.000 6],且2篇前瞻性队列研究、7篇回顾性研究中高氧血症组患者院内死亡率分别高于正常氧浓度组(P<0.05);高氧血症组患者出院后1年内神经系统恢复不良发生率高于正常氧浓度组[OR=1.66,95%CI(1.10,2.49),P=0.01],而2篇前瞻性队列研究、3篇回顾性研究中两组患者出院后1年内神经系统恢复不良发生率比较,差异均无统计学意义(P>0.05)。绘制漏斗图及行Egger's检验结果均显示,报道院内死亡率的文献无发表偏倚。结论现有文献证据表明,高氧血症可能增加成年心脏骤停患者院内死亡率及出院后1年内神经系统恢复不良发生率。Objective To evaluate the impact of hyperoxia on hospital mortality and nervous system 1-year after discharge in adult patients with sudden cardiac arrest.Methods Computer was used to search PubMed,EMBase and Registration Database of Cochrane Clinical Control Research Center,to screen studies about relationship between high oxygen treatment and hospital mortality,nervous system after 1-year discharge in adult patients with sudden cardiac arrest.According to PaO2 after treatment,research objects were divided into A group(with hyperoxia)and B group(with normal oxygen concentration),hospital mortality and nervous system 1-year after discharge was compared between the two groups;Review Manager v5.14 software was used to carry out the Meta-analysis.Results A total of 12 English literatures were involved eventually,including 3 prospective cohort studies(involving 9 643 patients),9 retrospective studies(involving 26 165 patients).Meta-analysis results showed that,hospital mortality in A group was statistically significantly higher than that in B group〔OR=1.38,95%CI(1.15,1.66),P=0.000 6〕,so was in the 2 involved prospective cohort studies and 7 involved retrospective studies(P<0.05);poor recovery ratio of nervous system 1-year after discharge in A group was statistically significantly higher than that in B group〔OR=1.66,95%CI(1.10,2.49),P=0.01〕,while no statistically significant difference of poor recovery ratio of nervous system 1-year after discharge was found between the two groups in the 2 involved prospective cohort studies or 3 involved retrospective studies(P>0.05).Funnel plot and Egger's test results showed that,no publication bias was found in the involved literatures reported hospital mortality.Conclusion Existing literature evidence suggests that,hyperoxia may increase the hospital mortality and poor recovery ratio of nervous system 1-year after discharge in adult patients with sudden cardiac arrest.

关 键 词：心脏骤停 成年人 高氧血症 死亡率 神经系统 META分析 

分 类 号：R541.78[医药卫生—心血管疾病]