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卒中后抑郁相关影响因素的Meta分析
张亚恒白树风闫俊强
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目的 探索脑卒中相关危险因素,为卒中后抑郁的早期诊断及预防决策提供依据。方法 标 准化检索万方、知网、维普、Medline、Cochrane 和Embase 有关卒中后抑郁相关性研究的文献,进一步提 取文献中相关因素的比值比(OR)及95%CI, 合并各个相关因素的OR值及95%CI以评估各因素在卒中后 抑郁中的作用。通过Egger's检验和敏感性分析评估各相关因素的偏倚风险和结果稳定性。结果 Meta 分析结果显示基底节区梗死(OR=2.83)、多病灶(OR=2.76)、额叶梗死(OR=2.47)、高改良Rankin 量表(mRS) 评分(OR=2.17)、缺乏家庭支持(OR=1.48)、高水平超敏C 反应蛋白(OR=1.35)、女性(OR=1.66)、高水平同型 半胱氨酸(OR=1.17)、高水平瘦素(OR=1.16)、高体质指数(BMI)(OR=1.16)、年龄(OR=1.07)为卒中后抑郁 的危险因素,而高受教育水平(OR=0.91)可能对卒中后抑郁具有保护作用。结论 高水平瘦素、高水平 BMI、高mRS 评分、多病灶、基底节区梗死、额叶梗死、缺乏家庭支持、女性、高水平超敏C 反应蛋白、高 水平同型半胱氨酸、年龄是卒中后抑郁的危险因素,高受教育水平可能对卒中后抑郁具有保护作用。
关键词:  卒中  抑郁  影响因素  Meta 分析
基金项目:
Meta-analysis of influence factor of post-stroke depression
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Abstract:
Objective To explore the risk factors related to stroke and provide evidence for early diagnosis and prevention of post-stroke depression. Methods An extensive search for related literature from the Wanfang data, CNKI, VIP, Medline, PubMed, Embase and the Cochrane Library was performed. The odds ratio( OR) of related factors in the literature and the confidence interval( 95%CI) were further extracted. The role of each factor in post-stroke depression was evaluated by combining OR and 95% CI. Egger's test and sensitivity analysis was used to evaluated the risk of bias and the stability of the results. Results The results of Meta analysis showed that the risk factors for post-stroke depression included basal nuclei lesion( OR=2.83), frontal lobe lesion(OR=2.47), multiple lesions( OR=2.76), high modified Rankin Scale( mRS) score( OR=2.17), lacked family support( OR=1.48), high-sensitivity C-reactive protein( OR=1.35), female( OR=1.66), high homocysteine (OR=1.17), high leptin( OR=1.16), high body mass index( OR=1.16), age( OR=1.07). While high education level (OR=0.91) may have a protective effect on post-stroke depression. Conclusions Basal nuclei lesion, multiple lesions, frontal lobe lesion, high mRS score, lacked family support, high-sensitivity c-reactive protein, female, high homocysteine, high leptin, body mass index, age are all risk factors for post-stroke depression, while education level may have protective effect on post-stroke depression.

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