中国抽动障碍患者预后及影响因素的系统评价

A systematic review of the prognosis and influencing factors of tic disorder in China

目的系统评价中国抽动障碍(TD)患者预后现状及影响因素,为改善患者预后提供更多的循证医学证据。方法检索Pubmend、Embase、Cochrane library、CBM、CNKI、VIP和万方数据库,检索时间均为建库至2017年8月,纳入评价TD患者预后及影响因素的文献,对预后不良率采用单组的Meta分析,对影响因素采取描述性分析。结果共纳入7篇文献,涉及1198例TD患者,年龄4~18岁。发表时间为1999~2016年。5项研究报道了TD患者预后不良的情况,Meta分析结果显示,预后不良的比率为32%,95%CI(0.18,0.57),影响TD患者预后的因素多种多样,其中病情严重程度、既往病史、共患病和病情反复频数为较为一致的影响因素。结论中国TD患者预后良好,病情严重程度、既往病史、共患病和病情反复频数为影响预后情况的因,但整体研究样本量不大和研究质量不高,建议未来研究中开展大样本、长时间的多中心研究,进一步探索TD患者预后情况和影响因素。

Objective To evaluate the prognosis and influencing factors of tic disorder（TD） in China, and provide evidence for improving the prognosis of patients. Method Pubmed, Embase, Cochrane library, CBM, CNKI, VIP and Wanfang database were searched up to August 2017, these studies which evaluated the prognosis or influencing factors for patients with TD were included. Meta analysis was used to evaluate the rate of poor prognosis, descriptive analysis was performed on the influencing factors. Results A total of 7 articles involving 1198 patients with TD, aged 4-18 years, were included. The publication time is 1999-2016 years. 5 studies reported the rate of poor prognosis, meta analysis showed that the rate of poor prognosis for 32%, 95% CI（0.18, 0.57）, many factors influence the prognosis of patients with TD, the severity of the disease, disease history, comorbidity and relapse frequency factors are more consistent factors. Conclusion The prognosis of patients with TD in China is good, the severity of the disease, disease history, comorbidity and relapse frequency could influence prognosis, however, the sample size of included studies is small and the quality is not high, future multi-centers studies with large sample and long time follow up are needed to explore the influencing factors on the prognosis of patients with TD.