华人精神分裂症吸烟患者首次发病前吸烟率的Meta分析

Rate of smoking before the first psychotic episode among Chinese schizophrenia smokers: a meta-analysis

目的系统评价华人精神分裂症吸烟患者首次精神病发作前的吸烟率(病前吸烟率)。方法计算机检索中国知网、万方、维普中文期刊网、台湾电子期刊全文数据库、PubMed、EMbase和PsycINFO,查找华人精神分裂症吸烟患者病前吸烟率的原始文献,检索时间均从建库至2016年12月25日。由两位研究者按纳入与排除标准筛选文献、提取数据并评价纳入研究的方法学质量,采用R 3.1.1进行Meta分析。结果共17项研究(2 445例精神分裂症吸烟患者)纳入分析,所有研究均为低质量。华人精神分裂症患者的合并病前吸烟率为72.0%(95%CI:61.0%~86.8%,P<0.01);亚组分析结果显示,近年发表(2012年-2016年)文献的病前吸烟率高于早年发表(2002年-2011年)文献(83.0%vs.61.0%,P=0.02),首发精神分裂症患者的病前吸烟率高于非首发患者(88.0%vs.67.0%,P=0.047)。结论大多数华人吸烟精神分裂症患者的吸烟行为发生在首次精神疾病发作之前。

Objective To comprehensively assess the rate of smoking before the first psychotic episode among Chinese schizophrenia smokers. Methods We searched CNKI, Wanfang, VIP, TEPS, PubMed, EMbase, and PsycINFO to collect studies that reported the rate of smoking before the first psychotic episode among Chinese schizophrenia smokers and were published by December 25 , 2016. Study inclusion, quality evaluation and data extraction were implemented independently by two authors. By using R 3. 1. 1, meta - analysis was conducted to pool rates of smoking before psychotic episode. Results A total of 17 studies, containing 2 445 Chinese schizophrenia smokers were included. However, all these included studies were of low quality. The pooled prevalence of smoking before the first psychotic episode among Chinese schizophrenia smokers was 72. 0% （95% C7 61. 0% -86. 8 % , P 〈0. 0 1 ） . In subgroup analysis, studies which were published in recent years had significantly higher prevalence than those published in earlier years （ 83. 0% vs. 61.0% ,P = 0. 02） and first - episode patients had significantly higher prevalence than non - first - episode patients （88.0% vs. 67.0% ,P= 0 .047） . Conclusion Most Chinese schizophrenia smokers smoke before the first psychotic episode.