高血压患者认知功能障碍影响因素Meta分析  

Influencing factors of cognitive impairment in patients with hypertension:a metaanalysis

作　　者：赵子冉 阳晓丽[1] 郭洪花[1] 夏燕 李文 谭春苗 张彩虹[1] ZHAO Ziran;YANG Xiaoli;GUO Honghua;XIA Yan;LI Wen;TAN Chunmiao;ZHANG Caihong(School of International Nursing,Hainan Medical University,Haikou 571199,P.R.China;Nursing Homes in Hainan Province,Haikou 570100,P.R.China;Department of Geriatrics,The First Affiliated Hospital of Hainan Medical University,Haikou 570102,P.R.China)

机构地区：[1]海南医学院国际护理学院,海口571199 [2]海南省托老院,海口570100 [3]海南医学院第一附属医院老年科,海口570102

出　　处：《中国循证医学杂志》2024年第5期577-583,共7页Chinese Journal of Evidence-based Medicine

基　　金：海南省自然科学基金项目(编号:820RC779,821RC560);海南省研究生创新科研课题(编号:Qhys2022-309)。

摘　　要：目的 系统评价高血压患者发生认知功能障碍(CI)的影响因素。方法 计算机检索PubMed、Web of Science、Embase、Cochrane Library、Ovid、Scopus、EBSCO、CNKI、WanFang Data、VIP和CBM数据库,检索时限均为建库至2023年3月,搜集有关高血压患者CI影响因素的研究。由2名研究者独立筛选文献,提取资料并评价纳入研究的偏倚风险后,使用RevMan 5.3和Stata 14.0软件进行Meta分析。结果 共纳入26篇文献,包括13 464名患者。Meta分析结果显示:降压药物的使用[OR=0.22,95%CI(0.09,0.59),P=0.002]、血压控制好[OR=0.48,95%CI(0.37,0.62),P<0.001]、社会支持[OR=0.94,95%CI(0.90,0.97),P<0.001]均是高血压患者发生CI的保护因素;而年龄[OR=1.17,95%CI(1.12,1.22),P<0.001]、年龄≥60岁[OR=2.10,95%CI(1.71,2.57),P<0.001]、女性[OR=1.55,95%CI(1.25,1.93),P<0.001]、单身[OR=2.39,95%CI(1.89,3.03),P<0.001]、吸烟[OR=3.40,95%CI(2.40,4.82),P<0.001]、文化程度(低于大专)[OR=3.46,95%CI(2.73,4.39),P<0.001]、受教育年限(≤12年)[OR=2.10,95%CI(1.43,3.07),P<0.001]、糖尿病[OR=2.82,95%CI(2.22,3.58),P<0.001]、高脂血症[OR=1.48,95%CI(1.10,2.00),P=0.01]、总胆固醇[OR=1.11,95%CI(1.01,1.22),P=0.02]、CVHI异常[OR=6.24,95%CI(3.75,10.37),P<0.001]、睡眠障碍[OR=2.92,95%CI(1.93,4.42),P<0.001]、收缩压[OR=1.04,95%CI(1.02,1.06),P<0.001]、直立性低血压[OR=1.39,95%CI(1.20,1.62),P<0.001]、高血压分级(2级)[OR=2.62,95%CI(1.83,3.73),P<0.001]、高血压分级(3级)[OR=3.15,95%CI(1.90,5.22),P<0.001]、应激史[OR=4.57,95%CI(2.86,7.30),P<0.001]均是发生CI的危险因素。结论 当前证据表明,高血压患者发生CI的影响因素较多,在今后对高血压患者发生CI的影响因素评估要更加全面。Objective To systematically review the factors for cognitive impairment in hypertensive patients.Methods PubMed,Web of Science,Embase,Cochrane Library,Ovid,Scopus,EBSCO,CNKI,WanFang Data,VIP and CBM databases were electronically searched to collect studies on factors for cognitive impairment in hypertensive patients from inception to March 2023.Two reviewers independently screened literature,extracted data and evaluated the risk of bias of the included studies.Meta-analysis was then performed by using RevMan 5.3 and Stata 14.0 software.Results A total of 26 articles involving 13464 patients were included.The results of meta-analysis showed that antihypertensive drug use(OR=0.22,95%CI 0.09 to 0.59,P=0.002),blood pressure was well controlled(OR=0.48,95%CI 0.37 to 0.623,P<0.001),and social support(OR=0.94,95%CI 0.90 to 0.97,P<0.001)were protective factors for CI in hypertensive patients.And age(OR=1.17,95%CI 1.12 to 1.22,P<0.001),age≥60(OR=2.10,95%CI 1.71 to 2.57,P<0.001),female(OR=1.55,95%CI 1.25 to 1.93,P<0.001),single(OR=2.39,95%CI 1.89 to 3.03,P<0.001),smoking(OR=3.40,95%CI 2.40 to 4.82,P<0.001),educational level(<college)(OR=3.46,95%CI 2.73 to 4.39,P<0.001),education years(≥12 years)(OR=2.10,95%CI 1.43 to 3.07,P<0.001),diabetes(OR=2.82,95%CI 2.22 to 3.58,P<0.001),hyperlipidemia(OR=1.48,95%CI 1.10 to 2.00,P=0.01),total cholesterol(OR=1.11,95%CI 1.01 to 1.22,P=0.02),CVHI anomalies(OR=6.24,95%CI 3.75 to 10.37,P<0.001),sleep disorder(OR=2.92,95%CI 1.93 to 4.42,P<0.001),systolic blood pressure(OR=1.04,95%CI 1.02 to 1.06,P<0.001),orthostatic hypotension(OR=1.39,95%CI 1.20 to 1.62,P<0.001,grade 2 hypertension(OR=2.62,95%CI 1.83 to 3.73,P<0.001),grade 3 hypertension(OR=3.15,95%CI 1.90 to 5.22,P<0.001),stress history(OR=4.57,95%CI 2.86 to 7.30,P<0.001)were all risk factors.Conclusion The current evidence shows that there are many factors affecting the incidence of CI in hypertensive patients,and the assessment of the factors affecting the incidence of cognitive dysfunction in hypertensive patients should be more com

关 键 词：高血压 认知功能障碍 影响因素 META分析 

分 类 号：R544.1[医药卫生—心血管疾病]