中国人群脑微出血患病率的Meta分析

Prevalence for Cerebral Microbleeds in China:a Meta-analysis

背景 脑微出血(CMBs)是严重危害我国国民健康的重要疾病,其发病率与年龄呈正相关。同时,CMBs也是卒中复发及诱发出血性脑卒中的独立危险因素。了解CMBs的患病现状对于推动我国健康老龄化进程及加强脑卒中防治工作具有重大现实意义。目的 系统评价我国CMBs发生的现况,为推进我国健康老龄化进程及加强脑卒中防治工作提供数据支撑。方法 系统检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、维普网(VIP)、PubMed、Embase、Web of Science等数据库中有关我国CMBs患病率的横断面研究,检索时限为建库至2023年11月。2名研究者分别对文献进行筛选、资料提取及纳入文献的偏倚风险评估,并采用Stata 16.0软件进行Meta分析。结果 共纳入39项研究,25 877例研究对象。Meta分析结果显示:我国CMBs的总体患病率为25.0%(95%CI=21.0%~29.0%)。亚组分析结果显示,51~60、61~70、71~80岁CMBs患病率分别为27.0%(95%CI=12.0%~44.0%)、23.0%(95%CI=16.0%~30.0%)、27.0%(95%CI=20.0%~35.0%);男、女性CMBs患病率分别为14.0%(95%CI=11.0%~18.0%)、10.0%(95%CI=8.0%~12.0%);华北、华东、华南、华中、西南、西北地区CMBs患病率分别为21.0%(95%CI=15.0%~28.0%)、26.0%(95%CI=21.0%~33.0%)、21.0%(95%CI=8.0%~39.0%)、21.0%(95%CI=16.0%~27.0%)、24.0%(95%CI=21.0%~27.0%)、46.0%(95%CI=41.0%~51.0%);有、无高血压病史CMBs患病率分别为19.0%(95%CI=13.0%~26.0%)、8.0%(95%CI=6.0%~11.0%);有、无吸烟史CMBs患病率分别为9.0%(95%CI=5.0%~14.0%)、16.0%(95%CI=12.0%~21.0%)。结论 我国CMBs总体患病率较高,不同年龄分段、地域及省份之间存在明显差异。高龄、男性、西北地区以及有高血压病史的人群发病率较高。受纳入研究数量和质量限制,该结论亟待更多高质量研究证实。

Background Cerebral microbleeds(CMBs)are important diseases that seriously endanger our national health,and their incidence is positively correlated with age.Meanwhile,CMBs are also an independent risk factor for stroke recurrence and induced hemorrhagic stroke.Understanding the current prevalence of CMBs is of great practical significance for promoting healthy aging and strengthening stroke prevention and treatment in China.Objective To systematically evaluate the current status of the occurrence of CMBs in China and to provide data support for promoting the process of healthy aging and strengthening the prevention and treatment of stroke in China.Methods Literature related to the occurrence of the disease of CMBs in our national population was systematically searched through Chinese and English databases such as CBM,CNKI,Wanfang Data,VIP,Pub Med,Embase,and Web of Science,with a timeframe of the establishment of the database until November 2023 for all searches.Two researchers separately performed literature screening,data extraction,and evaluation of the risk of bias in the included literature,and meta-analysis was performed using Stata 16.0 software.Results A total of 39 studies were included,with a total of 25 877 study subjects.Meta-analysis showed that the overall incidence of CMBs in China was 25.0%(95%CI=21.0%-29.0%).The results of subgroup analysis showed that the prevalence was 27.0%(95%CI=12.0%-44.0%)for those aged 51-60 years,23.0%(95%CI=16.0%-30.0%)for those aged 61-70 years,and 27.0%(95%CI=20.0%-35.0%)for those aged 71-80 years;the prevalence was 21.0%(95%CI=15.0%-28.0%)in North China,26.0%(95%CI=21.0%-33.0%)in East China,21.0%(95%CI=8.0%-39.0%)in South China,21.0%(95%CI=16.0%-27.0%)in Central China,24.0%(95%CI=21.0%-27.0%)in Southwest China and 46.0%(95%CI=41.0%-51.0%)in Northwest China by geographic area;the prevalence of CMBs with a history of hypertension was 19.0%(95%CI=13.0%-26.0%)and without a history of hypertension was 8.0%(95%CI=6.0%-11.0%);the prevalence of CMBs with a history of smoking was 9.0%(95%CI=5.0%-14.0%) and without a history of smoking was 16.0%(95%CI=12.0%-21.0%).Conclusion The overall prevalence of CMBs in China is high,with significant differences between different age segments,regions,and provinces.Its prevalence was higher in people of advanced age,males,Northwest China,and nationals with a history of hypertension.Due to the limitations in both quantity and quality of the included studies,further confirmation of this conclusion through additional high-quality research is required.