国内进展性缺血性脑卒中危险因素的Meta分析

发布时间：2018-03-02 15:44

本文选题：进展性缺血性脑卒中　切入点：危险因素　出处：《重庆医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：运用系统评价Meta分析方法综合评价高血压病史、脑卒中病史、高脂血症、糖尿病病史、冠心病病史、烟酒史、入院时纤维蛋白原增高、颈动脉狭窄、入院时高血压、高血糖、发热与我国人群进展性缺血性脑卒中关系的文献行系统评价，综合分析以上危险因素与我国人群进展性缺血性脑卒中的相关性，为制定脑卒中的预防决策提供循证依据。方法：通过计算机检索国内多个数据库，收集以上危险因素糖与我国人群进展性缺血性脑卒中的相关的流行病学文献，按Cochrane系统评价方法评估纳入文献的质量，并运用RevMan5.0软件对国内有关进展性缺血性脑卒中发病危险因素的研究结果进行定量综合分析；进行异质性检验以及合并OR值和95%可信区间的计算。结果：有5篇文献纳入本次研究，共有1489例患者，其中进展性缺血性脑卒中组480例，非进展组1009例。我国人群进展性缺血性脑卒中发生的各危险因素合并比值比(OR值)及95%可信区间(95%CI)分别为糖尿病病史2.31[1.70，3.28]、脑卒中病史1.84[1.37，2.46]、颈动脉狭窄1.39[1.07，1.79]、入院时高血糖3.18[1.84，5.48]、入院时发热3.33[1.77，6.28]，P值均0.05，有统计学意义；高血压病史、冠心病病史、烟酒史、入院时纤维蛋白原升高、入院时高血压合并OR值虽然均大于1,但是它们的95%CI均包含“1”，高脂血症合并OR值0.92，以上P值均0.05，无统计学意义。根据本研究所收集的资料特点，对各个不同危险因素分别进行敏感性及累积性分析，脑卒中病史、糖尿病病史、高血压病史、高脂血症、冠心病史及入院时发热及高血糖结果可靠，，可信度高；烟酒史、入院时纤维蛋白原增高及高血压、颈动脉狭窄结果稳定性差，可信度不高。结论：1、影响中国进展性缺血性脑卒中发病的主要危险因素为入院时发热、入院时高血糖、糖尿病病史、脑卒中病史、颈动脉狭窄； 2、以OR为效应指标，按照Wynder标准，糖尿病病史、入院时发热及高血糖与进展性缺血性脑卒中的发生呈中度关联，脑卒中病史及颈动脉狭窄与之呈弱关联。
[Abstract]:Objective: to evaluate the history of hypertension, stroke, hyperlipidemia, diabetes, coronary heart disease, alcohol and tobacco, increase of fibrinogen on admission, stenosis of carotid artery and hypertension on admission by Meta analysis. A systematic review of the relationship between hyperglycemia, fever and progressive ischemic stroke in Chinese population was carried out to analyze the correlation between the above risk factors and progressive ischemic stroke in Chinese population. To provide evidence-based basis for stroke prevention decision-making. Methods: a number of databases were searched by computer to collect the epidemiological literature on the relationship between the above risk factors sugar and progressive ischemic stroke in Chinese population. The quality of the literatures was evaluated according to the Cochrane system evaluation method. RevMan5.0 software was used to analyze the risk factors of progressive ischemic stroke in China quantitatively and synthetically. The heterogeneity test and the calculation of OR value and 95% confidence interval were also carried out. Results: a total of 1489 patients were included in this study, including 480 patients with progressive ischemic stroke. There were 1 009 cases in the non-progressive group. The ratio of risk factors associated with progressive ischemic stroke in Chinese population was higher than OR) and 95% CI (95 CI) was diabetes history 2.31 [1.703.28], stroke history 1.84 [1.3772.46], carotid stenosis 1.39 [1.071.79], and hyperglycemia on admission. 3.18 [1.84 卤5.48] and 3.33 [1.77 卤6.28] P values at admission, which were statistically significant. History of hypertension, history of coronary heart disease, history of tobacco and alcohol, increase of fibrinogen on admission, At admission, the OR values of hypertension complicated with hypertension were all greater than 1, but their 95 CI included "1", hyperlipidemia with OR value of 0.92and the above P values were 0.05. there was no statistical significance according to the characteristics of the data collected in this study. The history of stroke, diabetes, hypertension, hyperlipidemia, coronary heart disease, fever and hyperglycemia on admission were analyzed with high reliability and reliability. High fibrinogen and hypertension at admission, carotid artery stenosis results in poor stability, credibility is not high. Conclusion the main risk factors affecting progressive ischemic stroke in China are fever on admission, hyperglycemia on admission, history of diabetes, history of stroke and stenosis of carotid artery. 2. According to Wynder criteria, diabetes history, fever and hyperglycemia were moderately correlated with progressive ischemic stroke, and stroke history and carotid stenosis were weakly correlated with OR.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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