白蛋白水平与脑梗死后神经功能结局关系的meta分析

发布时间：2018-10-20 13:40

【摘要】：背景动物试验显示人血白蛋白治疗可能对脑梗死后神经功能恢复有促进作用，但临床试验少且结果不一致。目地评价人血白蛋白水平与脑梗死后神经功能临床结局之间的关系。材料与方法计算机检索了截止2013年7月在PubMed,Embase和Cochrane Library上的所有关于脑梗死后白蛋白水平与脑卒中结局的前瞻性临床队列研究。两名评价人员分别对被纳入的文献进行质量评价以及数据提取，并用revman5.2软件包对数据进行异质性检验、敏感性分析和定量合成。结果选出了25篇可能符合条件的文献,只有5篇进入最终的meta分析，患者总数为1029人。对4篇有死亡结局统计指标的文献进行异质性检验I2=0%(P=0.83)，使用固定效应模型计算结果：合并OR值为4.2(95%CI:2.70-6.55; P0.00001)，排除低质量文献后，合并OR值为4.03(95%CI:2.33-6.99; P0.00001)。对3篇有神经功能结局的统计指标的文献进行异质性检验I2=0%(P=0.98)，固定效应模型计算合并OR值为3.58(95%CI：2.18-5.87; P0.00001)，再采用随机效应模型合并OR值为3.59(95%CI,2.19-5.88; P0.00001)。表明结果可靠性较好。结论低白蛋白血症与神经功能恢复差和高死亡率相关。但本研究纳入文献数目较少，存在一定局限，需要更大规模前瞻性试验及临床随机对照试验来验证。
[Abstract]:Background Animal tests show that human serum albumin therapy may promote the recovery of neural function after cerebral infarction, but clinical trials are few and the results are inconsistent. Objective to evaluate the relationship between the level of human serum albumin (HSA) and the clinical outcome of neurological function after cerebral infarction. Materials and methods all prospective clinical cohort studies on postinfarction albumin levels and stroke outcomes in PubMed,Embase and Cochrane Library as of July 2013 were retrieved by computer. The two evaluators evaluated the quality of the included literature and extracted the data respectively. The data were tested for heterogeneity sensitivity analysis and quantitative synthesis with revman5.2 software package. Results 25 articles were selected, only 5 of them entered the final meta analysis. The total number of patients was 1029. Heterogeneity test was performed on 4 articles with statistical indicators of death outcome. The results of fixed effect model were as follows: the combined OR value was 4.2 (95 CI: 2.70-6.55; P 0.00001), and the combined OR value was 4.03 (95CIW 2.33-6.99; P0.00001). Heterogeneity test was performed on 3 papers with neurological outcomes. The fixed effect model was used to calculate the combined OR value of 3.58 (95 CI: 2.18-5.87; P0.00001), and the random effect model was used to combine the OR value with 3.59 (95CI2.19-5.88; P0.00001). It shows that the results are reliable. Conclusion hypoalbuminemia is associated with poor neurological function and high mortality. However, the number of literatures included in this study is relatively small and there are some limitations, which need to be verified by a larger prospective trial and a randomized controlled clinical trial.
【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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