帕金森病患者丘脑底核脑深部电刺激术后心率变异性的Meta分析

Alteration of heart rate variability in patients with Parkinson's disease after subthalamic nucleus deep brain stimulation: a Meta-analysis

目的系统评价丘脑底核脑深部电刺激术对帕金森病患者心率变异性的影响。方法以subthalamic nucleus、deep brain stimulation、DBS、STN、electrical stimulation、Parkinson disease、heart rate variability和帕金森病、脑深部电刺激、心率变异性等中英文检索词计算机检索2000年1月1日-2017年12月1日美国国立医学图书馆生物医学信息检索系统(Pub Med)、荷兰医学文摘(EMBASE/SCOPUS)、Cochrane图书馆、中国知网中国知识基础设施工程(CNKI)、万方数据库、维普数据库(VIP)等收录的关于帕金森病患者丘脑底核脑深部电刺激术后心率变异性变化的队列研究,采用心率变异性的高频部分(HF)、低频部分(LF)和低频部分/高频部分(LF/HF)作为评价指标,采用Newcastle-Ottawa量表(NOS)和Rev Man 5.3统计软件进行文献质量评价和Meta分析。结果共获得28篇英文文献,经剔除重复和不符合纳入标准者,最终纳入6项高质量(NOS评分7分)临床研究共101例行丘脑底核脑深部电刺激术的帕金森病患者。Meta分析显示,帕金森病患者丘脑底核脑深部电刺激术前后心率变异性之LF值(SMD=0.050,95%CI:-0.230~0.330;P=0.740)、HF值(SMD=0.160,95%CI:-0.120~0.430;P=0.270)和LF/HF比值(SMD=0.110,95%CI:-0.220~0.440;P=0.500)差异均无统计学意义。结论丘脑底核脑深部电刺激术不影响帕金森病患者的心率变异性。

Objective To evaluate the changes of heart rate variability （HRV） after subthalamic nucleus deep brain stimulation （STN-DBS） in patients with Parkinson＇s disease （PD）. Methods Retrieve relevant cohort studies from online databases （January 1, 2000-December 1, 2017） in PubMed, EMBASE/ SCOPUS, Cochrane Online Library, China National Knowledge Infrastructure （CNKI）, Wanfang Data and VIP database with key words： subthalamic nucleus, deep brain stimulation, DBS, STN, electrical stimulation, Parkinson disease, heart rate variability. Low-frequency power （LF）, high-frequency power （HF） and LF/HF of HRV were applied as evaluation indexes. Quality of studies was evaluated by using Newcastle-Ottawa Scale （NOS）. All data were pooled by RevMan 5.3 software for Meta-analysis. Results We enrolled 28 English articles, from which 6 studies with NOS score 7 were chosen after excluding duplicates and those not meeting the inclusion criteria. A total of 101 PD patients undergoing STN-DBS were included. Meta-analysis showed that there were no significant differences in the LF of HRV （SMD = 0.050, 95%CI： - 0.230-0.330; P = 0.740）, HF of HRV （SMD = 0.160, 95%CI： - 0.120-0.430; P = 0.270）, and LF/HF of HRV （SMD = 0.110, 95%CI： -0.220-0.440; P = 0.500） in patients with PD before and after the treatment of STN-DBS. Conclusions STN-DBS does not change HRV of patients with PD.