Objective:To screen risk factors for epilepsy after acute ischaemic stroke based on meta-analysis and cohort study and to establish a predictive model.Methods:Computer searches of MEDLINE,Embase,Cochrane library,Web o...Objective:To screen risk factors for epilepsy after acute ischaemic stroke based on meta-analysis and cohort study and to establish a predictive model.Methods:Computer searches of MEDLINE,Embase,Cochrane library,Web of Scinence,PubMed,CNKI,and WanFang Data data were conducted to collect literature on epilepsy after in acute ischemic stroke,from database creation to September 1,2022.The RRs and their 95%confidence intervals(CI)for risk factors for post stroke epilepsy were extracted for each study,and pooled estimates of the RRs and 95%CIs for each study were generated using either a random-effects model or a fixed-effects model.Beta coefficients for each risk factor were calculated based on the combined RR and their corresponding 95%CIs.The beta coefficients were multiplied by 10 and rounded.Results:Ten articles were identified for final inclusion in this meta-analysis,with a total of 141948 cases and 3702 cases of post stroke epilepsy.The risk factors included in the final risk prediction model were infarct size(RR 4.67,95%CI 1.41~15.47;P=0.01),stroke recuRRence(RR 2.48,95%CI 2.01~3.05;P<0.00001),stroke etiology(RR 1.70,95%CI 1.34~2.15;P<0.00001),stroke severity(RR 1.70,95%CI 1.34~2.15;P<0.00001),and stroke risk.stroke severity(RR 1.53,95%CI 1.39~1.70;P<0.00001),NIHSS score(RR 2.91,95%CI 1.64~5.61;P=0.0003),early-onset epilepsy(RR 5.62,95%CI 5.08~6.22;P<0.00001),cortical lesions(RR 3.83.95%CI 2.23~6.58;P<0.00001),total anterior circulation infarction(RR 18.94,95%CI 10.38~34.57;P<0.00001),partial anterior circulation infarction(RR 4.39,95%CI 2.29~8.40;P<0.00001),cardiovascular events(RR 1.78,95%CI 1.59~1.99;P<0.00001).Conclusion:Based on a systematic review and meta-analysis,we developed a simple risk prediction model for late epilepsy in baseline ischemic stroke that integrates clinical risk factors,including infarct size,stroke recurrence,stroke etiology,stroke severity,NIHSS score,early onset epilepsy,cortical lesions,stroke subtype,and cardiovascular events.展开更多
神经病理性疼痛困扰着数以百万人,目前,临床上对这种顽固性疼痛的治疗是一个紧迫的问题。一直以来,人们认为神经病理性疼痛是由神经元异常所引起的,近来大量研究表明,小胶质细胞对神经病理性疼痛的发生发展也起着重要作用。神经损伤后,T...神经病理性疼痛困扰着数以百万人,目前,临床上对这种顽固性疼痛的治疗是一个紧迫的问题。一直以来,人们认为神经病理性疼痛是由神经元异常所引起的,近来大量研究表明,小胶质细胞对神经病理性疼痛的发生发展也起着重要作用。神经损伤后,TREM2(triggering receptor expressed on myeloid cells 2)和DAP12(DNAX-activating protein of molecular mass 12 kDa)表达于脊髓背角的小胶质细胞,通过激活小胶质细胞,促进促炎因子分泌,从而加深了疼痛反应。展开更多
基金This study was supported by Hainan Provincial Key Research and Development Plan(ZDYF2021SHFZ092,ZDYF2022SHFZ109),Hainan Provincial Natural Science Foundation(822RC832)Hainan Provincial Clinical Medical Center(2021)Epilepsy Research Innovation Team of Hainan Medical College(2022)。
文摘Objective:To screen risk factors for epilepsy after acute ischaemic stroke based on meta-analysis and cohort study and to establish a predictive model.Methods:Computer searches of MEDLINE,Embase,Cochrane library,Web of Scinence,PubMed,CNKI,and WanFang Data data were conducted to collect literature on epilepsy after in acute ischemic stroke,from database creation to September 1,2022.The RRs and their 95%confidence intervals(CI)for risk factors for post stroke epilepsy were extracted for each study,and pooled estimates of the RRs and 95%CIs for each study were generated using either a random-effects model or a fixed-effects model.Beta coefficients for each risk factor were calculated based on the combined RR and their corresponding 95%CIs.The beta coefficients were multiplied by 10 and rounded.Results:Ten articles were identified for final inclusion in this meta-analysis,with a total of 141948 cases and 3702 cases of post stroke epilepsy.The risk factors included in the final risk prediction model were infarct size(RR 4.67,95%CI 1.41~15.47;P=0.01),stroke recuRRence(RR 2.48,95%CI 2.01~3.05;P<0.00001),stroke etiology(RR 1.70,95%CI 1.34~2.15;P<0.00001),stroke severity(RR 1.70,95%CI 1.34~2.15;P<0.00001),and stroke risk.stroke severity(RR 1.53,95%CI 1.39~1.70;P<0.00001),NIHSS score(RR 2.91,95%CI 1.64~5.61;P=0.0003),early-onset epilepsy(RR 5.62,95%CI 5.08~6.22;P<0.00001),cortical lesions(RR 3.83.95%CI 2.23~6.58;P<0.00001),total anterior circulation infarction(RR 18.94,95%CI 10.38~34.57;P<0.00001),partial anterior circulation infarction(RR 4.39,95%CI 2.29~8.40;P<0.00001),cardiovascular events(RR 1.78,95%CI 1.59~1.99;P<0.00001).Conclusion:Based on a systematic review and meta-analysis,we developed a simple risk prediction model for late epilepsy in baseline ischemic stroke that integrates clinical risk factors,including infarct size,stroke recurrence,stroke etiology,stroke severity,NIHSS score,early onset epilepsy,cortical lesions,stroke subtype,and cardiovascular events.
文摘神经病理性疼痛困扰着数以百万人,目前,临床上对这种顽固性疼痛的治疗是一个紧迫的问题。一直以来,人们认为神经病理性疼痛是由神经元异常所引起的,近来大量研究表明,小胶质细胞对神经病理性疼痛的发生发展也起着重要作用。神经损伤后,TREM2(triggering receptor expressed on myeloid cells 2)和DAP12(DNAX-activating protein of molecular mass 12 kDa)表达于脊髓背角的小胶质细胞,通过激活小胶质细胞,促进促炎因子分泌,从而加深了疼痛反应。
