影响帕金森病冲动控制障碍发生的相关因素的Meta分析

Meta-analysis of related factors of impulse control and related disorders in Parkinson's disease

目的探讨帕金森病(PD)冲动控制障碍(ICDs)发生的相关影响因素。方法检索Pub Med、MEDLINE、EMbase、Cochrane图书馆、中国期刊全文数据库、维普中文科技期刊全文数据库和万方数据库中2008年1月~2016年12月公开发表的关于PD ICDs相关因素研究的病例对照研究,采用纽卡斯尔-渥太华量表对入选文献进行质量评价,使用Rev Man 5.3软件进行Meta分析。结果纳入文献8篇。PD伴ICDs(PDICDs)组和PD不伴ICDs(PD-NICDs)组起病年龄、多巴胺受体激动剂每日等效剂量、左旋多巴每日等效剂量及男性、吸烟、使用多巴胺受体激动剂比率差异有统计学意义(均P<0.0),PD病程、Hoehn-Yahr分级、统一PD评价量表评分、MMSE评分及使用左旋多巴、使用金刚烷胺比率差异无统计学意义(均P>0.05)。PDICDs组及PD-NICDs组白色人种亚组起病年龄、男性比率、MMSE评分、使用金刚烷胺的比率、使用多巴胺受体激动剂的比率、多巴胺受体激动剂每日等效剂量、左旋多巴每日等效剂量差异有统计学意义(均P<0.05),黄色人种亚组PD病程、使用金刚烷胺的比率、多巴胺受体激动剂每日等效剂量、左旋多巴每日等效剂量差异有统计学意义(均P<0.05)。结论起病年龄早、男性、既往有吸烟史、使用多巴胺受体激动剂、多巴胺受体激动剂每日等效剂量较高和左旋多巴每日等效剂量较高是PD伴ICDs的影响因素。

Objective To explore related factors of impulse control and related disorders （ICDs） in Parkinson＇s disease （PD）. Methods PubMed, MEDLINE, EMBASE, Cochrane library, China national knowledge infrastructure, Chinese science and technology periodical full-text database and Wan fang database were used to search for case-control studies on risk factors of impulse control and related disorders in PD from 01/2008 ～ 12/2016. Newcastle-Ottawa scale was used to evaluate the quality of the literatures. All analyses were conducted with the software of Revman Manager 5.3. Results Eight clinical studies were included. Onset age, dopamine receptor agonist equivalent daily dose, Levodopa equivalent daily dose, and rates of male, smoking, dopamine receptor agonist use had significantly different between PD with ICDs （PD-ICDs） group and PD without ICDs （PD-NICDs） group （all P 〈 0. 05 ）, and there was no statistically significant difference in PD course, Hoehn-Yahr, unified Parkinson＇s disease rating scale Ⅲ score, MMSE score and levodopa using ratio and amantadine using ratio （ all P 〉 0. 05）. There were significantly difference in onset age, rate of male, MMSE score, amantadine using ratio, dopamine receptor agonist using ratio, dopamine receptor agonist equivalent daily dose, Levodopa equivalent daily dose in white race subgroup between PD-ICDs group and PD-NICDs group （ all P 〈 0. 05 ）. There were significantly difference in PD course, amantadine using ratio, dopamine receptor agonist equivalent daily dose, Levodopa equivalent daily dose in yellow race subgroup between PD-ICDs group and PD-NICDs group （all P 〈 0. 05 ）. Conclusion Early onset age, male, smoking, dopamine receptor agonist use, dopamine receptor agonist equivalent daily dose high, Levodopa equivalent daily dose high are risk factors of PD-ICDs.