特发性血小板减少性紫癜患者脑出血危险因素的Meta分析

Meta-analysis of influencing factors of cerebral hemorrhage in patients with idiopathic thrombocytopenic purpura

目的系统评价特发性血小板减少性紫癜患者脑出血的危险因素,为临床制定预防性干预措施提供参考。方法计算机检索中国知网、万方数据知识服务平台、维普数据库、中国生物医学文献数据库、PubMed、Embase及Cochrane Library中有关特发性血小板减少性紫癜患者脑出血危险因素的相关研究,检索时限为建库至2022年12月。采用RevMan 5.3软件进行Meta分析。结果最终纳入6篇文献,Meta分析结果显示:头部创伤[OR=0.11,95%CI(0.05,0.14)]、使用抗凝抗血小板药物[OR=0.07,95%CI(0.04,0.10)]、入院30 d内有感染病史[OR=0.16,95%CI(0.12,0.21)]、合并高血压[OR=0.13,95%CI(0.08,0.18)]、糖尿病[OR=0.12,95%CI(0.08,0.16)]、血小板计数<10×10^(9)/L[OR=0.49,95%CI(0.44,0.54)]以及有严重出血病史[OR=0.62,95%CI(0.56,0.69)]是特发性血小板减少性紫癜患者脑出血的危险因素。结论特发性血小板减少性紫癜患者脑出血的危险因素较多,医护人员需结合患者实际情况全面评估其脑出血风险,尽早给予个体化的干预手段,以降低特发性血小板减少性紫癜患者脑出血的发生风险。

Objective To systematically evaluate the risk factors of cerebral hemorrhage in patients with idiopathic thrombocytopenic purpura,so as to provide evidences for preventing cerebral hemorrhage.Methods Studies on the risk factors of cerebral hemorrhage in patients with idiopathic thrombocytopenic purpura were searched in such databases as CNKI,Wanfang,VIP,Chinese Biomedical Literature Database,PubMed,Embase and Cochrane Library,with the time setting from inception to December 2022.Meta-analysis was performed using RevMan 5.3 software.Results Six studies were included.According to the results of Meta-analysis,head trauma[OR=0.11,95%CI(0.05,0.14)],anticoagulant and antiplatelet drugs[OR=0.07,95%CI(0.04,0.10)],history of infection 30 days after admission[OR=0.16,95%CI(0.12,0.21)],hypertension[OR=0.13,95%CI(0.08,0.18)],diabetes[OR=0.12,95%CI(0.08,0.16)],platelet count<10×10^(9)/L[OR=0.49,95%CI(0.44,0.54)],and previous history of severe bleeding[OR=0.62,95%CI(0.56,0.69)]were risk factors.Conclusion Various factors can lead to cerebral hemorrhage in patients with idiopathic thrombocytopenic purpura.Therefore,medical staff need to assess the risk of cerebral hemorrhage of the patient and give individualized intervention as early as possible,to lower the risk of cerebral hemorrhage.