首次卒中患者卒中部位与卒中后抑郁相关性的Meta分析

The Relationship between stroke location and post-stroke depression in first-ever stroke patients:a Meta-analysis

目的系统评价首次卒中患者卒中部位与卒中后抑郁(PSD)的关系。方法检索中文科技期刊数据库(VIP)、中国期刊全文数据库(CNKI)、万方数据库、PubMed、ISI Web of Science、Ovid全文数据库、Elsevier Science Direct等国内外数据库1980年1月至2016年3月发表的卒中部位与PSD相关性的研究。采用RevMan5.3软件进行数据合并分析。结果共纳入14项研究,1 952例患者。Meta分析显示:首次卒中患者卒中部位与PSD的发生无直接相关性[随机效应模型,95%CI(0.89,1.43),P<0.01];亚组分析结果显示,使用汉密尔顿抑郁量表(HAMD)进行评估时右侧卒中部位与PSD的发生相关[固定效应模型,95%CI(1.21,1.76),P<0.01],而在卒中后的病程、卒中后患者有无失语上PSD的发生与卒中部位无明显相关性。结论首次卒中患者卒中部位与PSD不具有直接相关性,未来研究需作进一步的探讨。

Objective To systematically evaluate the relationship between stroke location and post-stroke depression （PSD） in first-ever stroke patients. Methods The studies on the relationship between stroke location and PSD published from January 1980 to March 2016 were retrieved from databases,including Chinese science and technology journal full-text database （VIP）, China journal full-text database （CNKI）,Wanfan database,PubMed,ISI Web of Science, Ovid database and Elsevier Science Direct. Rev- ManS. 3 software was adopted for data consolidation and analysis. Results A total of 14 studies,including 1 952 cases of patients were included. The meta analysis indicated that no direct relationship was found between stroke location and PSD in first-ever stroke patients [random effects model,95%CI（O. 89,1.43） ,P〈0.01]. The results of subgroup analysis indicated that the PSD was asso- ciated with the right hemisphere lesion when the Hamilton Depression Scale （HAMD） was adopted for assessment [fixed effects model,95%CI（1. 21,1. 76） ,P〈0.01] ,while the relationships were not found in the subgroup analysis of time course after stroke and the aphasia occurrence. Conclusion Stroke location may be not directly associated with PSD, further studies are needed to as- certain the relationship between stroke location and PSD.