中国人群血管性认知功能障碍部分危险因素的Meta分析

Risk factors of vascular cognitive impairment among Chinese population:Meta-analysis

目的:探讨中国人群血管性认知功能障碍(VCI)发生的主要危险因素,为VCI的防治提供科学依据。方法:计算机检索2002年1月—2013年1月PubMed数据库、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、中国科技期刊全文数据库(VIP)和万方数据库公开发表的有关中国人群VCI危险因素的观察性研究文献;采用Meta分析方法对文献进行定量综合分析,计算合并相对危险度(OR)或均差(MD)及其95%可信区间(95%CI)。结果:共纳入42篇合格文献,累计病例3 282例,对照7 815例。分类型变量因素与VCI关系的合并OR及OR 95%CI分别为:高血压2.56(2.03~3.21)、高血脂1.79(1.39~2.30)、高血糖2.46(1.90~3.19)、脑白质稀疏病变5.46(2.60~11.46)、脑梗死多发病灶4.39(2.61~7.38)、多次脑卒中史3.79(2.35~6.11)、左半球梗死病变2.13(1.42~3.20)、吸烟1.51(1.08~2.11)、饮酒0.99(0.73~1.36)、基底节部位梗死2.15(1.55~2.99)和丘脑部位梗死2.34(1.57~3.47);连续型变量因素与VCI关系的MD及MD95%CI分别为:甘油三酯水平0.35(0.15~0.55)、总胆固醇水平0.44(-0.16~1.04)、叶酸水平-4.10(-5.50^-2.69)和维生素B12水平-130.44(-225.46^-35.41)。结论:除饮酒和总胆固醇水平外,高血压、高血脂、高血糖、脑白质稀疏病变、脑梗死多发病灶、多次脑卒中史、左半球梗死病变、吸烟、基底节部位梗死、丘脑部位梗死、甘油三酯水平高、叶酸水平低和维生素B12水平低均可能是中国人群VCI发生的危险因素。

Objective To explore the risk factors of vascular cognitive impairment （VCI）among Chinese population, and to clarify the scientific evidences for further prevention and treatment.Methods PubMed,CNKI,CBM,VIP and Wangfang databases （from 2002.1 to 2013.1）were searched to collect case-control studies or cohort studies studying risk factors of VCI among Chinese population. Meta-analysis was performed to calculate combined odds ratio （OR）or mean difference （MD）and its 95% confidence interval （95%CI）.Results A total of 42 proper papers involving 3 282 cases and 7 815 controls were included in the review.For categorical variables,pooled OR＆amp;nbsp;and its 95% CI were as follows：hypertension 2.56 （2.03 - 3.21 ）, hyperlipidemia1.79 （1.39 - 2.30 ）, hyperglycemia 2.46 （1.90-3.19）,Leukoaraiosis 5.46 （2.60-11.46）,cerebral infraction multiple foci 4.39 （2.61-7.38）,stroke history3.79（2.35-6.11）,left hemisphere lesions 2.13（1.42-3.20）,smoking 1.51 （1.08-2.11）,drinking 0.99（0.73-1.36）,basal ganglia lesions 2.15（1.55-2.99）,thalamus lesions 2.34（1.57-3.47）;for continuous variables,MD and its 95%CI were as follows：level of TG 0.35（0.15-0.55）,level of TC 0.44（-0.16-1.04）,level of folic acid -4.10（-5.50- -2.69）,vitamin B12 -130.44（-225.46--35.41）.Conclusion Except for drinking and level of TC, hypertension, hyperlipidemia, hyperglycemia, leukoaraiosis,cerebral infraction multiple foci,stroke history,left hemisphere lesions,smoking,basal ganglia lesions,thalamus lesions,high level of TG,low level of folic acid and vitamin B12 might be the risk factors of VCI among Chinese population.