脑卒中后疲劳危险因素的Meta分析

Risk factors for post-stroke fatigue:a Meta-analysis

目的通过循证医学方法分析脑卒中后疲劳相关危险因素。方法分别以post-strokefatigue、PSF、factor、prevalence、risk factor 等英文词汇作为检索词,检索美国国立医学图书馆生物医学信息检索系统(PubMed)、荷兰医学文摘(EMBASE/SCOPUS)、英国Cochrane 图书馆等数据库中关于脑卒中后疲劳危险因素的随机对照试验、病例对照研究、队列研究和回顾性病例系列研究结果;采用Jadad 量表和Stata 12.0 统计软件进行文献质量评价和Meta 分析。结果共获得6986 篇文献,经剔除重复和不符合纳入标准者,最终获得23 项临床研究计9135 例脑卒中后疲劳患者。分析显示,脑卒中前疲劳(OR =4.790,95%CI:0.790 ~ 29.160;P = 0.000)、抑郁(OR = 3.530,95%CI:2.580 ~ 4.850;P = 0.000)、焦虑(OR =1.200,95%CI:1.070 ~ 1.350;P = 0.041)是脑卒中后疲劳的危险因素。结论脑卒中前疲劳、抑郁、焦虑是脑卒中后疲劳的危险因素,临床医师应重视相关危险因素,早期预防并治疗,提高脑卒中患者的生活质量。

Objective Evidence-based medicine was used to analyze the risk factors associated with post-stroke fatigue(PSF).Methods Words such as post-stroke fatigue,PSF,factor,prevalence,risk factor were used as search terms.Computer searches were performed by PubMed,EMBASE/SCOPUS and Cochrane Library.Databases were used to search for randomized controlled trials,case-control studies,cohort studies and retrospective case series on PSF risk factors.The Jadad Scale and Stata 12.0 statistical software were used for literature quality assessment and Meta-analysis.Results A total of 6986 articles were obtained.After eliminating duplicates and non-compliance criteria,a total of 9135 patients with PSF were included in 23 clinical studies.Meta-analysis showed pre-stroke fatigue(OR=4.790,95% CI:0.790-29.160;P=0.000),depression(OR=3.530,95%CI:2.580-4.850;P=0.000),anxiety(OR=1.200,95%CI:1.070-1.350;P=0.041) are risk factors for PSF.Conclusions Pre-stroke fatigue,depression and anxiety are risk factors for PSF.Clinicians should pay attention to relevant risk factors,early prevention and treatment,and improve the quality of life of patients with stroke.