主动脉夹层合并低氧血症危险因素的Meta分析

Meta-analysis of risk factor for aortic dissection complicated with hypoxemia

目的系统评价主动脉夹层(AD)合并低氧血症的危险因素。方法计算机检索PubMed、Embase、CENTRAL、Web of Science、中国知网、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库中AD合并低氧血症的相关研究,检索时间为建库至2021年12月。由两名研究者独立筛选文献、提取资料并进行质量评价,采用RevMan 5.3软件进行Meta分析。结果共纳入17篇文献,共计3452例AD患者,其中低氧血症1439例,共纳入23个独立危险因素,AD合并低氧血症发生率为20.50%~60.97%。Meta分析结果显示,年龄、体重指数、C-反应蛋白、白细胞介素-6、D-二聚体、吸烟史、合并胸腔积液、夹层累及范围均是AD合并低氧血症的独立危险因素(P<0.05);白细胞计数与AD合并低氧血症无关(P>0.05)。结论年龄、体重指数、吸烟史、胸腔积液、夹层累及范围、C-反应蛋白、白细胞介素-6、D-二聚体均是AD合并低氧血症的危险因素,可用于识别高危AD合并低氧血症患者,为临床治疗提供指导。

Objective To systematically evaluate the risk factors for hypoxemia of aortic dissection(AD).Method PubMed,Embase,CENTRAL,Web of Science,CNKI,Wanfang Database,VIP,and CBM were searched by computer for related literatures on AD combined with hypoxemia.The retrieval time was set from the establishment of the database to December 2021.Two researchers independently screened the literature,extracted data,and evaluated the quality.RevMan 5.3 software was used for Meta-analysis.Result A total of 17 articles with 3452 AD patients were included,including 1439 patients with hypoxemia.A total of 23 independent risk factors were included,and the incidence of AD complicated with hypoxemia was 20.50%-60.97%.Meta-analysis results showed that age,body mass index,C-reactive protein,interleukin-6,D-dimer,smoking history,combined pleural effusion,and extent of dissection were independent risk factors for AD combined with hypoxemia(P<0.05);while white blood cell count was not associated with AD with hypoxemia(P>0.05).Conclusion Age,body mass index,smoking history,pleural effusion,the extent of dissection,C-reactive protein,interleukin-6,and D-dimer are all risk factors for AD complicated with hypoxemia.These terms should be used to identify high-risk AD complicated with hypoxemia patients,and the evaluation based on these terms has guiding significance for clinical treatment.