中国老年人退行性心脏瓣膜病临床危险因素的Meta分析

Risk factors of senile degenerative heart valve disease in elderly people in China:a Meta⁃analysis

目的 对中国地区老年人退行性心脏瓣膜病(SDHVD)的研究进行Meta分析,探讨该疾病的危险因素。方法根据系统评价和荟萃分析的首选报告项目(PRISMA)指南进行了Meta分析。系统检索了11个数据库(包括PubMed、Web of Science、Cochrane、Embase、Ovid、 Scopus、知网、维普、万方、中华医学杂志数据库和中国生物医学文献数据库)有关SDHVD的文章,检索时间选择从建库起至2023年3月15日。由2名研究员根据纳入和排除标准进行文献筛选、质量评价和数据提取,使用软件Stata 17.0进行Meta分析。结果 共纳入18篇文献,研究类型包括横断面研究和病例对照研究,共涉及10 121名老年人。在控制混杂变量之后,以下危险因素与中国老年人发生SDHVD有关:年龄[WMD=4.29,95%CI(1.84~6.74),I^(2)=94.5%,P<0.05]、吸烟[OR=1.32,95%CI(1.00~1.73),I^(2)=78.9%,P<0.05]、高血压[OR=1.93,95%CI(1.75~2.13),I^(2)=0,P<0.001]、高脂血症[OR=1.66,95%CI(1.40~1.97),I^(2)=2.4%,P<0.001]、糖尿病[OR=1.33,95%CI(1.05~1.69),I^(2)=60.6%,P<0.05]、冠心病[OR=2.12,95%CI(1.60~2.80),I^(2)=67.4%,P<0.001]、骨质疏松[OR=3.42,95%CI(2.07~5.65),I^(2)=0,P<0.001。结论 年龄、吸烟、高血压、高脂血症、糖尿病、冠心病和骨质疏松被确定为中国老年人SDHVD的危险因素。

Objective To explore risk factors of senile degenerative heart valve disease(SDHVD)in the elderly in China by Meta analysis.Methods Meta‐analysis was conducted according to preferred reporting items for systematic reviews and Meta‐analyses(PRISMA)guidelines for systematic review and Meta‐analysis.Eleven electronic databases,including PubMed,Web of Science,Cochrane,Embase,Ovid,Scopus,CNKI,VIP database,Wan Fang database,The National Medical Journal of China,and SinoMed database,were retrieved from their inception to March 15,2023.The articles about SDHVD were searched systematically.Literature screening,quality evaluation and data extraction were independently conducted by 2 researchers according to the inclusion and exclusion criteria.Meta‐analysis was performed by Stata17.0.Results A total of 18 articles(including cross‐sectional study and case‐control study)were included,involving 10121 elderly people.After controlling the confounding variables,the following risk factors were related to SDHVD in elderly people in China:age(WMD=4.29,95%CI:1.84‐6.74,I^(2)=94.5%,P<0.05),smoking(OR=1.32,95%CI:1.00‐1.73,I^(2)=78.9%,P<0.05),hypertension(OR=1.93,95%CI:1.75‐2.13,I^(2)=0,P<0.001),hyperlipidemia(OR=1.66,95%CI:1.40‐1.97,I^(2)=2.4%,P<0.001),diabetes mellitus(OR=1.33,95%CI:1.05‐1.69,I^(2)=60.6%,P<0.05),coronary artery disease(OR=2.12,95%CI:1.60‐2.80,I^(2)=67.4%,P<0.001),osteoporosis(OR=3.42,95%CI:2.07‐5.65,I^(2)=0,P<0.001),blood phosphorus(OR=‐0.02,95%CI:‐0.05‐0.02,I^(2)=0,P>0.05).Conclusion Age,smoking,hypertension,hyperlipidemia,diabetes mellitus,coronary artery disease,and osteoporosis are the risk factors of SDHVD in elderly people.