烟雾病行血运重建术患者发生脑卒中的危险因素meta分析  

Meta-analysis on risk factors for stroke in patients undergoing revascularization for moyamoya disease

作　　者：肖彬新[1] 吴翠娟 王玫[1] 钟晓勇[1] XIAO Binxin;WU Cuijuan;WANG Mei;ZHONG Xiaoyong(The People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fujian,Fuzhou 350004,China;Fujian University of Traditional Chinese Medicine,Fujian,Fuzhou 350122,China)

机构地区：[1]福建中医药大学附属人民医院,福建福州350004 [2]福建中医药大学,福建福州350122

出　　处：《中国医药科学》2023年第17期40-44,56,共6页China Medicine And Pharmacy

基　　金：国家中医临床研究基地专项课题(JDZX201935;JDZX2019043);福建省卫生健康中青年骨干人才培养项目(2022GGA045)。

摘　　要：目的 系统评价烟雾病行血运重建术患者发生脑卒中的危险因素。方法 检索中国知网、万方、维普、Cochrane、PubMed、Embase数据库,筛选关于烟雾病行血运重建术患者发生脑卒中的影响因素的文献,检索时间从建库至2022年12月31日。文献检索、文献筛选、质量评价和数据收集由2名研究者独立进行,选用Stata 16.0软件进行meta分析。结果 共纳入16篇文献,共计2678例患者。meta分析结果显示:大脑后动脉受累[OR=3.08,95%CI(2.23,4.26)]、合并糖尿病[OR=4.84,95%CI(2.22,10.55)]、吸烟[OR=8.81,95%CI(2.66,29.14)]、高铃木分期[OR=2.05,95%CI(1.35,3.11)]、既往短暂性脑缺血发作(TIA)发作[OR=2.92,95%CI(1.78,4.80)]、既往脑卒中发作[OR=4.90,95%CI(2.75,8.73)]、脑血管储备不良[OR=2.23,95%CI(1.56,3.18)]与烟雾病行血运重建术患者发生脑卒中相关。结论 大脑后动脉受累、合并糖尿病、吸烟、高铃木分期、既往TIA发作、既往脑卒中发作、脑血管储备不良是烟雾病行血运重建患者发生脑卒中的危险因素,应加强烟雾病行血运重建术的围手术期管理,警惕脑卒中的发生。Objective To systematically evaluate the risk factors for stroke in patients undergoing revascularization for moyamoya disease.Methods The literature on factors influencing the occurrence of stroke in patients undergoing revascularization for moyamoya disease included in the China National Knowledge Internet,Wanfang,VIP,Cochrane,PubMed and Embase databases from the date of database establishment to December 31,2022 was screened.The literature retrieval,literature screening,quality evaluation and data collection were performed independently by two researchers,and STATA 16.0 software was selected for Meta-analysis.Results 16 studies with a total of 2678 patients were included in this study.Meta-analysis results showed that posterior cerebral artery involvement(OR=3.08,95%CI[2.23,4.26]),comorbid diabetes mellitus(OR=4.84,95%CI[2.22,10.55]),smoking(OR=8.81,95%CI[2.66,29.14]),high Suzuki stage(OR=2.05,95%CI[1.35,3.11]),previous transient ischemic attack(TIA)(OR=2.92,95%CI[1.78,4.80]),previous stroke episodes(OR=4.90,95%CI[2.75,8.73]),poor cerebrovascular reserve(OR=2.23,95%CI[1.56,3.18])were associated with the occurrence of stroke in patients undergoing revascularization for moyamoya disease.Conclusion Posterior cerebral artery involvement,comorbid diabetes mellitus,smoking,high Suzuki stage,previous TIA,previous stroke episode,and poor cerebrovascular reserve are risk factors for stroke in patients undergoing revascularization for moyamoya disease,and perioperative management of revascularization for moyamoya disease should be strengthened to be alert for stroke.

关 键 词：烟雾病 脑血管重建术 脑卒中 危险因素 META分析 

分 类 号：R651.1[医药卫生—外科学]