肝硬化病人衰弱发生率及影响因素的Meta分析  

Incidence and influencing factors of frailty in patients with liver cirrhosis:a Meta-analysis

作　　者：陆雅维 张会 许静[1] 仲蕾 项晓婷 LU Yawei;ZHANG Hui;XU Jing;ZHONG Lei;XIANG Xiaoting(School of Nursing,Anhui Medical University,Anhui 230601 China)

机构地区：[1]安徽医科大学护理学院,安徽230601 [2]安徽医科大学第一附属医院 [3]安徽省公共卫生临床中心

出　　处：《循证护理》2024年第16期2851-2856,共6页Chinese Evidence-Based Nursing

基　　金：国家重点研发计划主动健康和老龄化科技应对重点专项,编号:2020YFC2006500;安徽医科大学护理学院研究生青苗培育项目,编号:hlqml2024071。

摘　　要：目的:系统评价肝硬化病人衰弱发生率及其影响因素。方法:对the Cochrane Library、Web of Science、PubMed、EMbase、中国知网、万方数据库、维普数据库、中国生物医学文献数据库进行检索,检索时限从建库至2023年6月。由2名研究者独立进行文献筛选、资料提取和质量评价。采用Stata 14.0和RevMan 5.3软件进行统计分析。结果:共纳入19篇文献,涉及7 437例病人。Meta分析结果显示,肝硬化病人衰弱患病率为27%,其中年龄[OR=1.04,95%CI(1.02,1.07),P=0.002]、酒精性肝硬化[OR=1.47,95%CI(1.08,1.99),P=0.01]、血清清蛋白[OR=0.68,95%CI(0.51,0.92),P=0.01]、肝病血清钠(MELD-Na)评分[OR=1.08,95%CI(1.07,1.09),P<0.001]、腹腔积液[OR=2.14,95%CI(1.47,3.13),P<0.001]、肝性脑病[OR=2.48,95%CI(1.95,3.15),P<0.001]是肝硬化病人衰弱发生的影响因素。结论:现有证据表明,肝硬化病人衰弱发生率较高,年龄、酒精性肝硬化、MELD-Na评分、腹腔积液、肝性脑病、血清清蛋白是肝硬化病人衰弱的影响因素。因此,临床中对发生衰弱的肝硬化病人应进行早期识别,并采取针对性干预措施以延缓或逆转其不良健康结局。Objective:To evaluate the incidence of frailty in patients with liver cirrhosis and its influencing factors.Methods:the Cochrane Library,Web of Science,PubMed,EMbase,CNKI,WanFang Database,VIP,and CBM were searched from the establishment of the database to June 2023.Literature selection,data extraction and quality evaluation were conducted independently by two researchers.Stata 14.0 and RevMan 5.3 software were used for statistical analysis.Results:A total of 19 articles were included,involving 7437 patients.Meta-analysis showed that the prevalence of asthenia in cirrhotic patients was 27%.The major influencing factors for frailty included age(OR=1.04,95%CI 1.02-1.07,P=0.002),etiologic alcoholic cirrhosis(OR=1.47,95%CI 1.08-1.99,P=0.01),albumin(OR=0.68,95%CI 0.51-0.92,P=0.01),MELD-Na score(OR=1.08,95%CI 1.07-1.09,P<0.001),ascites(OR=2.14,95%CI 1.47-3.13,P<0.001),hepatic encephalopathy(OR=2.48,95%CI 1.95-3.15,P<0.001).Conclusions:Available evidence suggests that patients with cirrhosis have a higher incidence of frailty.Age,etiological alcoholic cirrhosis,MELD-Na score,ascites,hepatic encephalopathy,and albumin are the influencing factors for frailty in cirrhotic patients.Therefore,it is suggested that early identification and a series of intervention measures should be taken to delay or reverse the development of patients with debilitating cirrhosis.

关 键 词：肝硬化 衰弱 影响因素 META分析 循证护理 

分 类 号：R473.5[医药卫生—护理学]