腔隙性脑梗死患者认知障碍危险因素meta分析

Meta-analysis of the risk factors for cognitive impairment in the patients with lacunar cerebral infarction

目的对腔隙性脑梗死患者认知障碍危险因素进行meta分析。方法通过计算机检索PubMed、Embase、Cochrane Library、中国知网、万方数据知识服务平台、维普资讯中文期刊服务平台等数据库公开发表的关于腔隙性脑梗死患者认知障碍危险因素分析的病例对照研究,检索时间为建库至2021年7月26日。由2名研究员独立完成文献筛选、方法学质量评价及资料提取,应用RevMan5.3软件对合并纳入文献数大于或等于3条的危险因素进行meta分析。结果最终纳入18篇文献,共2893例患者。腔隙性脑梗死患者认知障碍危险因素为受教育程度、年龄、高血压病史、糖尿病病史、高脂血症、同型半胱氨酸水平、脑白质病变、超敏C反应蛋白水平、吸烟和病变部位(优势比=0.56、1.20、3.74、4.29、4.07、2.40、4.09、2.37、2.38、4.80,95%可信区间:0.38~0.85、1.05~1.38、2.37~5.91、3.19~5.76、2.69~6.15、1.35~4.20、2.75~6.08、1.61~3.50、1.33~4.25、3.11~7.41)。结论腔隙性脑梗死患者认知障碍受多种因素影响,对可控因素应尽早采取干预措施。

Objective To conduct the meta-analysis on the risk factors of cognitive impairment in the patients with lacunar cerebral infarction.Methods PubMed,Embase,Cochrane Library,China national knowledge infrastructure(CNKI),Wanfang Data Knowledge Service Platform and VIP Information Chinese Journal Service Platform were searched by computer,to retrieve the case-control cases on the risk factors analysis of cognitive impairment in the patients with lacunar cerebral infarction,from the establishment of the database to July 26,2021.A total of two researchers independently completed the literature screening,methodological quality evaluation and data extraction.RevMan 5.3software was used to perform the meta-analysis on risk factors with more than or equal to three included literatures.Results A total of 18articles were finally included,including 2893patients.The risk factors for cognitive impairment in the patients with lacunar infarction were the education level,age,history of hypertension,history of diabetes,hyperlipidemia,homocysteine level,leukoencephalopathy,high-sensitivity C-reactive protein level,smoking and lesion site(OR=0.56,1.20,3.74,4.29,4.07,2.40,4.09,2.37,2.38,4.80;95%CI:0.38-0.85,1.05-1.38,2.37-5.91,3.19-5.76,2.69-6.15,1.35-4.20,2.75-6.08,1.61-3.50,1.33-4.25,3.11-7.41).Conclusion The cognitive impairment in the patients with lacunar infarction is affected by many factors,and the intervention measures should be taken as soon as possible for controllable factors.