眼底血管异常与缺血性脑白质病变关系的Meta分析

发布时间：2018-05-23 07:19

本文选题：眼底 + 脑白质病变　；参考：《山西医科大学》2014年硕士论文

【摘要】：目的系统评价眼底血管异常与缺血性脑白质病变（WMLs）的关系。方法计算机检索Cochrane图书馆(2013年第四期)、Medline(1950年－2013年)、Embase(1980年－2013年)、中国生物医学文献数据库(CBMdisc，1978年－2013年)、中国学术期刊全文数据库(CNKI，1979年－2013年)、中文科技期刊全文数据库(VIP，1989年－2013年)、万方数据库(1978年－2013年)、中文生物医学会议文献数据库(CMCA，1994年－2013年)等，收集国内外有关眼底血管异常与缺血性脑白质病变的病例对照研究。按Cochrane系统评价的方法，由两名研究者独立的进行质量评价和资料提取，对文献研究结果进行Meta分析、定性评价以及倒漏斗图分析等。在Meta分析过程中应用Cochrane协作网提供的RevMan5.2软件进行，依据异质性检验的结果选择固定效应模型或随机效应模型，检验水准为α=0.05，估计综合评价指标的95%可信区间。结果共纳入4篇文献，样本量为2159例，，其中病例组（WMLs组）495例，对照组（非WMLs组）1664例。存在眼底血管异常的人患WMLs的危险性是未暴露此因素者的2.98倍[OR=2.98,95%CI（2.23，3.99），P0.00001]。综合本研究所纳入的文献，共有的眼底血管异常指标包括：动静脉交叉征、动脉狭窄、渗出、眼底出血及微动脉瘤。存在动静脉交叉征者患WMLs的危险性是未暴露此因素（动静脉交叉征）者的2.26倍[OR=2.26,95%CI（1.70，3.00），P0.00001]；存在眼底动脉狭窄者患WMLs的危险性是未暴露此因素（动脉狭窄）者的2.37倍[OR=2.37,95%CI（1.70，3.28），P0.00001]；存在渗出者患WMLs的危险性是未暴露此因素（渗出）者的2.52倍[OR=2.52,95%C（I1.56，4.07），P=0.0002]；存在眼底出血者患WMLs的危险性是未暴露此因素（出血）者的2.55倍[OR=2.55,95%CI（1.51，4.30），P=0.0004]；微动脉瘤[OR=1.56,95%CI（0.36，6.72），P=0.55]对WMLs发生的影响无统计学意义。结论眼底血管异常增加了WMLs发生的危险性；眼底血管异常的观察指标中动静脉交叉征、动脉狭窄、眼底出血及渗出均与WMLs的发生有关，微动脉瘤对WMLs发生的影响无统计学意义。
[Abstract]:Objective to evaluate the relationship between fundus vascular abnormalities and ischemic white matter lesions (WMLs). Methods the Cochrane Library (fourth issue of Medline, 1950-2013, 1980-2013, China Biomedical Literature Database, 1978-2013, China academic Journal Full-text Database, 1979-2013, VIP1989, China academic Journal Full-text Database) was searched by computer. -2013, Wanfang database (1978-2013, CMCA, 1994-2013), etc. Case-control study of abnormal fundus vessels and ischemic leukoencephalopathy at home and abroad was collected. According to the method of Cochrane system evaluation, two researchers independently carried out quality evaluation and data extraction, and carried out Meta analysis, qualitative evaluation and inverted funnel map analysis on the results of literature research. In the process of Meta analysis, the RevMan5.2 software provided by Cochrane cooperation network is used. According to the results of heterogeneity test, the fixed effect model or random effect model is selected. The test level is 伪 -0.05, and the 95% confidence interval of the comprehensive evaluation index is estimated. Results A total of 4 articles were included, with a sample size of 2159 cases, including 495 cases in the WMLs group and 1 664 cases in the control group (non-WMLs group). People with abnormal fundus vessels were 2.98 times more likely to develop WMLs than those without exposure. According to the literature, the common indicators of ocular fundus vascular abnormalities include arteriovenous cross sign, arterial stenosis, exudation, fundus hemorrhage and microaneurysm. The risk of WMLs in patients with arteriovenous cross syndrome was 2.26 times as high as that in those with no exposure (arteriovenous cross syndrome) [OR2.2695 CII 1.70 3.00 P0.00001]; the risk of WMLs in patients with ophthalmic artery stenosis was 2.37 times as high as that in unexposed patients [OR2.3795CI1.703.28] and the risk of WMLs was 2.37 times as high as that of non-exposed patients [OR2.3795CI1.703.28 / P0.00001], and the risk of WMLs in patients with arteriovenous artery stenosis was 2.37 times higher than that in patients with non-exposed arteriovenous cross syndrome (AVM). The risk of WMLs in exudators was 2.52 times as high as that in those not exposed (exudation). The risk of WMLs in patients with fundus hemorrhage was 2.55 times higher than that in those without exposure (bleeding). There was no statistical significance in the influence of arterioaneurysm [OR1.5695CI0.36.72P0.55] on the occurrence of WMLs. Conclusion the abnormal fundus vessels increase the risk of WMLs, the arteriovenous cross sign, arterial stenosis, fundus hemorrhage and exudation are all related to the occurrence of WMLs, and the influence of microaneurysm on the occurrence of WMLs is not statistically significant.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R742

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