糖尿病/高血糖对脑出血预后的影响:动物实验meta分析

Influence of diabetes/hyperglycemia on the prognosis of intracranial hemorrhage:A metaanalysis based on animal experiments

目的通过提取动物实验相关数据,分析糖尿病/高血糖对脑出血预后的影响。方法系统检索中国知网、万方、PubMed、WebofScience、CochraneLibrary和Embase数据库,检索时间截止2021年11月1日。收集关于高血糖/糖尿病与脑出血的动物实验研究。严格按照纳入、排除标准进行筛选,采用随机效应模型或固定效应模型估计合并率及95%可信区间。采用SYRCLE动物实验偏倚风险评估工具进行质量评价。将最终纳入的研究通过ReviewManager 5.3软件进行meta分析,以研究糖尿病/高血糖对脑出血预后的影响。结果共纳入7篇动物实验,meta分析结果显示,在脑出血动物模型中,糖尿病/高血糖组血肿体积大于对照组(SMD=1.2,95%CI=0.13~2.27,P<0.05)。进一步进行亚组分析,两组的前3 d血肿体积未见明显差异(SMD=0.68,95%CI=⁃0.38~1.74,P>0.05);两组的第7天血肿体积存在差异性,糖尿病/高血糖组血肿体积大于对照组(SMD=3.26,95%CI=0.21~6.31,P<0.05)。糖尿病/高血糖组血肿周围水肿(PHE)大于对照组(MD=1.57,95%CI=0.71~2.44,P<0.05)。糖尿病/高血糖组神经功能评分大于对照组(SMD=1.06,95%CI=0.50~1.62,P<0.05)。结论在动物实验中,糖尿病/高血糖可增加脑出血的血肿体积、PHE,从而影响脑出血预后。

Objective To investigate the influence of diabetes/hyperglycemia on the prognosis of intracranial hemorrhage by extracting related data from animal experiments.Methods CNKI,Wanfang Data,PubMed,Web of Science,the Cochrane Library,and Embase were systematically searched for related animal experiments of diabetes/hyperglycemia and intracranial hemorrhage published up to November 1,2021.Screening was performed in strict accordance with inclusion and exclusion criteria,and a random effects model or a fixed effects model was used to estimate pooled rate and 95%confidence interval(CI).The SYRCLE tool for assessing risk of bias was used for quality assessment.Review Manager 5.3 software was used to perform a metaanalysis of the experiments included to investigate the influence of diabetes/hyperglycemia on the prognosis of intracranial hemorrhage.Results A total of 7 animal experiments were included,and the metaanalysis showed that in the animal model of intracerebral hemorrhage,the diabetes/hyperglycemia group had a significantly larger hematoma volume than the control group[standardized mean difference(SMD)=1.2,95%CI:0.132.27,P<0.05].Further subgroup analysis showed that there was no significant difference in hematoma volume between the two groups within the first 3 days(SMD=0.68,95%CI:0.38 to 1.74,P>0.05),while the diabetes/hyperglycemia group had a significantly larger hematoma volume than the control group on day 7(SMD=3.26,95%CI:0.216.31,P>0.05).The diabetes/hyperglycemia group had a significantly higher degree of perihematomal edema(PHE)than the control group[mean difference(MD)=1.57,95%CI:0.712.44,P<0.05].The diabetes/hyperglycemia group had a significantly higher neurological function score than the control group(SMD=1.06,95%CI:0.501.62,P<0.05).Conclusions In animal experiments,diabetes/hyperglycemia can increase hematoma volume and the degree of PHE,thereby affecting the prognosis of intracerebral hemorrhage.