体质指数与心脏再同步化治疗预后的meta分析

Body mass index and prognosis of cardiac resynchronization therapy:a meta-analysis

目的:本文主要选取已经发表的文章,系统性评价体质指数(BMI)对心脏再同步化治疗(CRT)临床结局的影响。方法:通过PubMed数据库、Embase数据库、Cochrane图书馆、中国知网全文数据库、万方数据库使用关键词检索查找截至2019年12月已发表的文献,最终选入5篇文献,共纳入19593例患者。这些患者根据BMI的不同分为4类,即低体重、正常体重、超重及肥胖,对这些文献进行meta分析。结果:与正常体重患者相比,低体重患者全因死亡事件发生较高(OR:1.52,95%CI:1.24~1.87,I^2=0%,P<0.001),而超重和肥胖患者全因死亡事件较低(OR:0.65,95%CI:0.60~0.71,I^2=21%,P<0.001;OR:0.52,95%CI:0.48~0.56,I^2=0%,P<0.001),差异有统计学意义(P<0.05)。结论:在接受CRT的患者中,低体重的患者预后较差,而肥胖或超重的患者预后较好。

Objective:This article mainly selects published articles to systematically evaluate the effect of body mass index(BMI)on the clinical outcome of cardiac resynchronization therapy(CRT).Method:The published articles up to December 2019 were searched by Pubmed,Embase,Cochrane Library databases,CNKI,WanFang Data databases.Finally,5 articles were selected and a total of 19593 patients was included.These patients were divided into four categories according to their body mass index,namely low body weight,normal weight,overweight and obesity.Meta analysis was performed on these literatures.Result:Compared with normal weight patients,the incidence of all-cause death was higher in low-weight patients(OR:1.52,95%CI:1.24-1.87,I^2=0%,P<0.001),while lower in overweight and obese patients(OR:0.65,95%CI:0.60-0.71,I^2=21%,P<0.001;OR:0.52,95%CI:0.48-0.56,I^2=0%,P<0.001).The difference was significant statistically(P<0.05).Conclusion:Among patients receiving CRT,patients with low body weight have a poor prognosis,while those who are obese or overweight have a better prognosis.