脑卒中患者血清胱抑素C水平与卒中后认知障碍相关性的Meta分析

Meta Analysis of the Correlation between Cystatin C Level in Stroke Patientis and Post Stroke Cognitive Impairment

目的 应用Meta系统评价脑卒中患者血清胱抑素C(Cystatin C,Cys C)水平与卒中后认知障碍(post-stroke cognitive impairment,PSCI)的相关性。方法 通过检索PubMed,EMBASE,Web of Science,The Cochrane Library,WANFANG,谷歌学术、中国知网(CNKI)和维普中文期刊数据库(VIP),收集关于PSCI和Cys C相关性的文献。检索时间自数据库建库至2020年12月。对符合纳入标准的文献提取相关信息,采用RevMan 5.3及Stata14.0统计软件进行Meta分析。结果 共纳入10项研究,病例组728例,对照组898例。Meta分析结果显示:PSCI组血清Cys C水平明显高于对照组(MD=0.37,95%CI:0.25~0.49,P <0.000 01),病例组按照PSCI病程时间进行亚组分析,结果显示病程<14天与≥14天PSCI亚组患者血清CysC水平均高于对照组(MD=0.39,95%CI:0.11~0.68,P <0.000 01;MD=0.41,95%CI:0.17~0.66,P <0.000 01),差异均有统计学意义。结论 PSCI患者的血清Cys C水平高于卒中后认知正常患者,为PSCI早期识别与筛查提供了部分客观的医学证据。

Objective To evaluate the correlation between cognitive impairment after stroke and the levels of cystatin C in stroke patientis by the system of Meta. Methods The databases including PubMed,Embase,Web of Science,the Cochrane Library,WanFang,Google Scholar,CNKI and VIP were searched to collect the literature about post stroke cognitive impairment and cystain C.The retrieval time was from the establishment of the database to December 2020. Extract the relevant information on literature met the inclusion criteria, using RevMan 5. 3 and Stata14. 0 statistical software Meta-analysis. Results Ten studies were included, with 728 cases in the case group and 898 cases in the control group.Meta analysis results showed that the level of serum Cys C in the PSCI group was significantly higher than that in the control group(MD=0.37, 95%CI: 0.25 ~0.49, P < 0.000 01). Subgroup analysis was conducted according to the course of PSCI.The results showed that the serum Cys C level of the PSCI group was higher than that of the control group in the <14 days group and the ≥ 14 days group(MD=0.39, 95%CI: 0.11 ~ 0.68, P < 0.000 01;MD=0.41, 95%CI: 0.17 ~ 0.66, P < 0.000 01), the differences were statistically significant(all P < 0.05). Conclusion The results of this study indicated that the serum Cys C level of PSCI patients was higher than that of patients with normal post-stroke cognition, which provides some objective evidence-based medical evidence for the early identification and screening of PSCI.