体质指数与心房颤动病人死亡率相关性的Meta分析  

Correlation between body mass index and mortality of patients with atrial fibrillation:a Meta-analysis

作　　者：王婷婷 章琪[2] 石层层 桂珊珊 曹子璇 王如婷 魏亚倩 王珍[1] WANG Tingting;ZHANG Qi;SHI Cengceng;GUI Shanshan;CAO Zixuan;WANG Ruting;WEI Yaqian;WANG Zhen(Huzhou University,Zhejiang 313000 China)

机构地区：[1]湖州师范学院,浙江313000 [2]湖州市第一人民医院

出　　处：《护理研究》2020年第20期3572-3579,共8页Chinese Nursing Research

基　　金：湖州市科技局公益性技术应用研究(一般)项目,编号:2018GY13。

摘　　要：[目的]探讨不同水平体质指数(BMI)与心房颤动病人全因死亡率及心血管疾病死亡率的关系。[方法]系统检索PubMed、EMbase、Web of Science、The Cochrane Library、中国知网(CNKI)、万方、维普数据库,检索时间自建库至2019年8月31日。由两名研究者分别独立提取数据,核对无误后应用RevMan 5.3软件进行数据合并。合格文献限定于研究BMI和心房颤动死亡率相关性的队列研究,BMI至少分2组,研究结果呈现各组死亡的相对风险比(HR)及95%置信区间(95%CI)。[结果]最终纳入11篇文献,其中1篇为回顾性队列研究,1篇为随机对照试验的事后分析,其余均为前瞻性队列研究,共包含54685例心房颤动病人。Meta分析结果显示:全因死亡率,与正常体质指数组比较,低体质指数组死亡率更高[HR=1.89,95%CI(1.28,2.80),P=0.001],超重组死亡率更低[HR=0.73,95%CI(0.68,0.79),P<0.00001],肥胖组死亡率也更低[HR=0.65,95%CI(0.60,0.72),P<0.00001]。心血管疾病死亡率,与正常体质指数组比较,低体质指数组死亡率更高[HR=2.49,95%CI(1.38,4.50),P=0.003],超重组死亡率更低[HR=0.70,95%CI(0.59,0.85),P=0.0002],肥胖组死亡率也更低[HR=0.73,95%CI(0.59,0.91),P=0.005]。[结论]当前证据显示,超重和肥胖可降低心房颤动病人的死亡率,而低体重则增加了心房颤动病人的死亡率。Objective:To explore the relationship between body mass index(BMI)at different levels and all-cause mortality and cardiovascular disease mortality in patients with atrial fibrillation.Method:Related literatures were systematicly retrieved from PubMed,EMbase,Web of Science,The Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Data,and VIP databases from the ostablishment of database until August 31,2019.Two researchers independently extracted the data,checked,and used RevMan5.3 software to merge the data.Eligible literatures were limited to cohort studies on the correlation between BMI and atrial fibrillation mortality.The BMI was divided into at least two groups.The results presented a relative risk ratio(HR)and a 95%confidence interval(95%CI)of death in each group.Results:Eleven articles were finally included:one retrospective cohort study,one post-mortem analysis of a randomized controlled trial(RCT),and nine prospective cohort studies,involving 54685 patients with atrial fibrillation.Meta-analysis results showed that:compared with the normal group,the mortality of the low BMI group was higher[HR=1.89,95%CI(1.28,2.80),P=0.001],and the mortality of the overweight group was lower[HR=0.73,95%CI(0.68,0.79),P<0.00001],and the mortality of obese BMI group was also lower[HR=0.65,95%CI(0.60,0.72),P<0.00001].The mortality of cardiovascular disease,compared with the normal group,in the low BMI group was higher[HR=2.49,95%CI(1.38,4.50),P=0.003],and the mortality in the overweight group was lower[HR=0.70,95%CI(0.59,0.85),P=0.0002],the mortality in the obese group was also lower[HR=0.73,95%CI(0.59,0.91),P=0.005].Conclusions:Current evidence showed that overweight and obesity could reduce the mortality of patients with atrial fibrillation,while low weight could increase the mortality of patients with atrial fibrillation.

关 键 词：体质指数 心房颤动 死亡率 META分析 心血管疾病 

分 类 号：R47[医药卫生—护理学]