临床荟萃 ›› 2023, Vol. 38 ›› Issue (10): 878-882.doi: 10.3969/j.issn.1004-583X.2023.10.002

• 循证研究 • 上一篇    下一篇

不安腿综合征在肌萎缩侧索硬化患者的患病率及其与疾病严重程度相关性的meta分析

孙亚南1, 郝一峰2, 李晓红1()   

  1. 1.大连市友谊医院 神经内科, 辽宁 大连 116001
    2.深圳市龙岗区上善堂诊所,广东 深圳 518116
  • 收稿日期:2023-05-15 出版日期:2023-10-20 发布日期:2024-01-03
  • 通讯作者: 李晓红 E-mail:xhlihh@126.com

Prevalence of restless legs syndrome in patients with amyotrophic lateral sclerosis and its correlation with disease severity: A meta-analysis

Sun Yanan1, Hao Yifeng2, Li Xiaohong1()   

  1. 1. Department of Neurology,Dalian Municipal Friendship Hospital, Dalian 116001,China
    2. Department of Keyuan Community Health Service Center,Shenzhen Longgang District Second People's Hospital,Shenzhen 518116,China
  • Received:2023-05-15 Online:2023-10-20 Published:2024-01-03
  • Contact: Li Xiaohong E-mail:xhlihh@126.com

摘要: 目的 系统评价不安腿综合征(Restless legs syndrome,RLS)在肌萎缩侧索硬化(Amyotrophic lateral sclerosis, ALS)患者的患病率及其与疾病严重程度的相关性。方法 计算机检索Cochrane图书馆、美国国立医学图书馆(PubMed)、荷兰医学文摘(Embase)、Web of science、中国生物医学文献库(CBM)、中国知网(CNKI)、万方医学数据库(Wanfang data),收集有关ALS患者不安腿综合征的相关研究,检索时间为建库至2020-12-12。由两名研究者按照纳入标准及排除标准筛选文献,按照纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale, NOS)对纳入的病例对照研究和队列研究进行质量评价。应用Revman5.3软件进行数据合并与发表偏倚检测。 结果 共纳入6篇文献,其中2篇队列研究,4篇病例对照研究,所有研究的NOS评分均≥6分。Meta分析结果显示RLS患病率在ALS患者中显著增加(OR=8.24,95%CI =4.57~14.87)。ALS亚组分析显示RLS阳性组白日过度嗜睡(EDS)比例显著增加(OR=3.42,95%CI =1.61~7.27,P =0.001); RLS阳性组ALSFRS-R评分较阴性组显著减低,提示功能缺损更加显著(MD=-3.76,95%CI =-7.16~-0.36,P =0.03)。本研究存在轻度的发表偏倚。结论 RLS在ALS患者的患病率明显增加,且会影响患者睡眠质量,合并有RLS的ALS患者功能缺损更加显著,应引起临床医生的重视。

关键词: 肌萎缩侧索硬化, 睡眠障碍, 不安腿综合征, Meta分析

Abstract: Objective To evaluate the prevalence of restless legs syndrome (RLS) in patients with amyotrophic lateral sclerosis (ALS) and its correlation with disease severity. Methods Relevant articles reporting RLS in ALS patients published before December 12th 2020 were systematically searched in the Cochrane library, PubMed, Embase, Web of science, Chinese Biomedical Literature Database (CBM), CNKI, and Wanfang Data. According to the inclusion and exclusion criteria, eligible studies were selected independently by two researchers. Quality of case-control studies and cohort studies was assessed according to the Newcastle-Ottawa Scale (NOS). Data pooling and publication bias were analyzed using Revman5.3. Results A total of 6 eligible studies were included into the analysis, including 2 cohort studies and 4 case-control studies. The NOS scores of all studies were ≥6. Meta-analysis showed that the prevalence of RLS increased significantly in ALS patients(OR=8.24,95%CI =4.57-14.87). Subgroup analysis showed that the proportion of excessive daytime sleepiness (EDS) in the RLS-positive group was significantly higher than that of the RLS-negative group (OR=3.42, 95%CI =1.61-7.27, P=0.001).The ALS Functional Rating Scale-Revised (ALFRS-R) score of ALS patients in RLS-positive group was significantly lower than that of the RLS-negative group, indicating that the functional impairment was more significant in ALS patients with RLS (MD=-3.76, 95%CI =-7.16, -0.36, P=0.03). The meta-analysis showed a slight publication bias. Conclusion The prevalence of RLS in ALS patients is significantly elevated, which affects their sleep quality. The functional defect of ALS patients with RLS is more significant, which should be well concerned.

Key words: amyotrophic lateral sclerosis, sleep disorders, restless legs syndrome, meta analysis

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