摘要
目的针对中国原发性醛固酮增多症(primary aldosteronism,PA)患者,经肾上腺切除术后高血压的预后情况进行Meta分析并评价影响其预后的因素。方法在中国知网、万方、维普、PubMed、Embase、Cochrane等数据库中,查找从建库至2020年7月有关中国PA患者行肾上腺切除术并随访其预后的研究。文献筛选、数据提取及文献质量评价工作分别由两位研究人员单独进行。笔者采用Stata14.0软件进行Meta分析。结果共纳入19项回顾性研究,包括1753例患者。中国PA患者术后高血压合并治愈率为62%(95%CI:51.4%~72.5%)。亚组分析显示,随访患者总人数<50例的治愈率为73%(95%CI:57.5%~88.5%),≥50例的治愈率为57.3%(95%CI:44.3%~70.2%)。以随访时间0.5年分组,两组治愈率比较,差异无统计学意义。此外,治愈组体重指数(body mass index,BMI)及年龄较非治愈组偏低,治愈组高血压病程较非治愈组偏短。结论中国PA患者肾上腺切除术后高血压治愈率处于国际较高水平,但仍需进行更大临床试验以建立有效的术前预测模型。
Objective To systematically evaluate the hypertension outcomes afteradrenalectomy in patients with primary aldosteronism(PA)and the prognostic factors.Methods Comprehensive electronic searches of China National Knowledge Internet,WanFang,VIP,PubMed,Embase and Cochrane databases were performed from initial state to july,2020.Our search included studies on the outcome of adrenalectomyin PA patients in China.Literature screening,data extraction and literature quality evaluation were carried out separately by two researchers.The software used for meta-analysis was stata14.0.Results We included 19 retrospective studies,including 1753 subjects.The combined cure rate of hypertension after adrenalectomy was 62%(95%CI:51.4%-72.5%).Our subgroup analysis showed that when the total number of patients was less than 50,the cure rate was 73%(95%CI:57.5%-88.5%).When the total num-ber of patients was more than 50,the cure rate was 57.3%(95%CI:44.3%-70.2%).According to the follow-up time of 0.5 years,there was no significant difference in the cure rate between the two groups.The BMI of the cured group was lower than that of the non cured group,the age of the cured group was lower than that of the non cured group,and the duration of hypertension in the cured group was shorter than that in the non cured group.Conclusion The cure rate of hypertension after adrenale-ctomy in Chinese population is at a high international level.Larger clinical trials are still needed to establish an effective preoperative prediction model.
作者
李可立
骆秦
曹梅
洪静
Li Keli;Luo Qin;Cao Mei(Hypertension Center of People′s Hospital of Xinjiang Uygur Autonomous Region,Xinjiang Hypertension Institute,National Health Committee Key Laboratory of Hypertension Clinical Research,Xinjiang 830001,China)
出处
《医学研究杂志》
2021年第9期50-54,共5页
Journal of Medical Research
基金
新疆维吾尔自治区自然科学基金资助项目(2018D01C133)。
