脑出血患者早期高血糖与其近期死亡率相关性的Meta分析

Relationship between early hyperglycemia and the short-term death rate in patients with spontaneous intracerebral hemorrhage:a meta-analysis

目的探讨自发性脑出血患者早期高血糖与其近期死亡率的相关性。方法检索PubMed、Embase、Cochran、万方数据库、维普咨询网、CNKI数据库等，搜索和筛选目前发表的以“早期高血糖与自发性脑出血患者近期死亡率关系”为主要研究内容的文献，提取整理相关数据。采用Meta分析评估高血糖组和非高血糖组近期死亡率RR值及95％CI，并进行发表偏倚分析。结果共纳入8篇文献，研究对象3756例。高血糖切点范围：6．1～8．3mmol／L；中位数切点：7．5mmol／L。与高血糖相关的近期死亡率RR=3．65，95％CI：3．08～4．33，P〈0．01。亚组分析，A组：RR=3．46，95％CI：1．66～7．20，P=0．09；B组：RR=3．49，95％CI：2．89～4．21，P〈0．01。发表偏倚均显示，Egger’s test（P〉0．1），Begg’s test（P〉0．05），Nfs0．05远大于纳入文献数量。结论早期高血糖增加自发性脑出血患者近期死亡风险，亚组分析尚未发现其关系受高血糖切点的影响。

Objective To investigate the relationship between early hyperglycemia and the shortterm death rate in patients with spontaneous intracerebral hemorrhage（ICH）. Methods The databases from PubMed, Embase, Coehran, Wanfang, VIP and CNKI were searched and the literatures about the association of early hyperglycemia with short-term death rate in patients with intraeerebral hemorrhage were extracted, and then the related data was analyzed. The short-term death relative risk （RR） and 95% confidence interval （CI） in the hyperglycemia group and the non-hyperglycemia group were calculated using a software RevMan 4.2. Finally, possible publication bias was tested . Results ＇ Totally 8 literatures including 3756 patients were obtained. Cutoff points for defining hyperglycemia varied across studies （6.1 to 8. 3 mmol/L） and the median cutoff value was 7.5mmol/L. The RR value for short-term death associated with hyperglycemia was 3.65 （95%CI：3.08-4. 33,P〈0. 01）. The RR were 3.46 （95% CI： 1.66 % 7.20; P = 0.09） and 3.49 （95% CI： 2.89 % 4, 21, P〈0. 0001） for groups A and B in sub- analysis respectively. The publication bias showed that the results of Egger＇ s test was less than 0.01 , P values of Begg＇s test was less than 0. 05, and Nfs0.05 exceeded enrolled literatures. Conclusion Early hyperglycemia can significantly increase the short-term death risk in patients with spontaneous intracerebral hemorrhage, which is independent of the cutoff points for defining hyperglycemia in sub- analysis.