摘要
目的系统评价阻塞性睡眠呼吸暂停(Ostructive Sleep Apnea,OSA)对中国脑卒中患者预后的影响。方法计算机检索PubMed、EMbase、The Cochrane Library、Sinomed、CNKI、Wan Fang Data和Vip数据库,搜集OSA与中国脑卒中患者预后相关性的队列研究,检索时限均从建库至2021-07。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用Stata 16.0软件进行Meta分析。结果共纳入研究9项,包括638例患者。Meta分析结果显示:与对照组相比,合并OSA的中国脑卒中患者预后更差,随访1个月[MD=3.11,95%CI(2.42,3.79),P<0.001]、3个月[MD=2.05,95%CI(1.35,2.76),P<0.001]和6个月[MD=2.98,95%CI(0.68,5.28),P=0.01]后其神经功能缺损的NIHSS评分和1个月[MD=0.60,95%CI(0.25,0.95),P<0.001]、3个月[MD=0.7,95%CI(0.49,0.91),P<0.001]及6个月[MD=0.71,95%CI(0.53,0.89),P<0.001]的mRS评分均高于对照组;同时合并OSA的中国脑卒中患者1个月[MD=-9.34,95%CI(-14.37,-4.30),P<0.001]、3个月[MD=-6.92,95%CI(-9.44,-4.40),P<0.001]和6个月[MD=-5.96,95%CI(-9.57,-2.34),P<0.001]的功能依赖更高,基于Barthel指数的日常生活活动能力评分均低于非OSA组。结论当前证据显示,相比于对照组,OSA对中国脑卒中患者的短期预后(神经功能缺损和功能依赖)有一定的影响。受纳入研究的数量和随访时长的限制,上述结论尚需开展更多高质量研究予以验证。
Objective To systematically review on the prognosis of Chinese stroke patients with OSA. Methods PubMed,EMbase, The Cochrane Library, Sinomed, CNKI, Wan Fang Data and Vip were electronically searched by collecting cohort studies on the relationship between OSA and the prognosis of Chinese stroke patients until to July, 2021. Two reviewers independently screened literature,extracted data and evaluated risk of bias of included studies, then, meta analysis was performed by using Stata16.0 software. Results A total of 9 studies involving 638 objects were included. The results of meta analysis showed that: the prognosis of Chinese stroke patients with OSA was worse than control group. Followed up for 1 month [MD=3.11, 95%CI(2.42, 3.79), P<0.001], 3 months [MD=2.05, 95%CI(1.35,2.76), P<0.001] and 6 months [MD=2.98, 95%CI(0.68, 5.28), P=0.01], the NIHSS scores of neurological of the patients were impaired and the mRS scores of 1 month [MD=0.60, 95%CI(0.25, 0.95), P<0.001], 3 months [MD=0.7, 95%CI(0.49, 0.91), P<0.001] and 6 months [MD=0.71, 95%CI(0.53, 0.89), P<0.001] were all higher than control group. At the same time, Chinese stroke patients with OSA had higher functional dependence at 1 month [MD=-9.34, 95%CI(-14.37,-4.30), P<0.001], 3 months [MD=-6.92, 95%CI(-9.4,-4.40), P<0.001]and 6 months [MD=-5.96, 95%CI(-9.57,-2.34), P<0.001]. The scores of daily activity ability based on Barthel index were lower than non-OSA group. Conclusion The current evidence shows that OSA has a certain effect on the short-term prognosis(neurologic deficits and functional dependency) of Chinese stroke patients compared with the control group. Due to limited quality and follow up times of the included studies, more high quality studies are required to verify above conclusions.
作者
仲琳
苏小凤
何子君
刘霖
韩继明
ZHONG Lin;SU Xiaofeng;HE Zijun;LIU lin;HAN Jiming(Medical College,Yan'an University,Yan'an 716000,China;Department of Respiratory and Critical Care Medicine of the Second Medical Center,Chinese PLA General Hospital,Beijing 100853,China;National Clinical Research Center for Geriatric Diseases,General Hospital of PLA,Beijing 100853,China)
出处
《中华灾害救援医学》
2022年第1期8-14,共7页
Chinese Journal of Disaster Medicine
