颈动脉粥样硬化斑块分布特点的Meta分析

A Meta-analysis of Distribution of Carotid Artery Atherosclerotic Plaques in Patients with Atherosclerotic

目的系统评价颈总动脉斑块分布特点对颈动脉粥样硬化的影响。方法按Cochrane系统评价方法,计算机检索Cochrane图书馆、CENTRAL、MEDLINE、EMBASE、SCI、CBM、CNKI等数据库,并手工检索相关会议文献及已发表与未发表的资料。检索语言为中英文。按照纳入标准严格筛选文献,并进行文献方法学质量评价,对可以合并分析的数据采用Cochrane协作网提供的RevMan 5.1软件进行Meta分析。结果经过全面检索及筛查后,共纳入5个随机对照研究。Meta分析结果显示:颈总动脉斑块左右侧分布率差异有统计学意义,左侧多于右侧,比值比0.72,95%可信区间0.67～0.78,P<0.00001。结论颈总动脉斑块的形成表现为左侧多于右侧,并且左侧更能提示颈动脉粥样硬化的程度;因本系统评价仍有一些未纳入的评价指标,上述结论需更多设计严谨的随机对照试验加以验证。

Objective To assess distributions of carotid plaque in patients with atherosclerosis in the carotid arteries. Methods We electronically searched the Cochrane Library, CENTRAL, MEDLINE, EMBASE, SCI, CBM and CNKI databases; we also hand-searched some published and unpublished references and meeting papers. Languages were restricted to Chinese and English. We strictly adopted references according to inclusion criteria. The studies were evaluated by literature methodology. The Cochrane Collaboration＇s RevMan 5.1 software was used for meta analysis. Results We identified 5 randomized control trials after comprehensively searching and selecting. The results showed statistically significant differences in carotid plaque distributions, and the incidence of those with plaque in the left side was higher than the right side, OR=0.72, 95%CI （0.67, 0.78）, P〈0.000 01. Conclusions Compared with the right side, the plaque formation in the left side of common carotid artery were more frequency, while the distribution of left side might be indicated the degree of atherosclerosis than the right side. There were some criteria not included in this systematic evaluation, and thus more high quality RCT should be recruited and assessed in future study.