中国人尿酸水平与急性缺血性脑卒中患者预后关系的meta分析

doi:10.3969/j.issn.1004-583X.2022.09.003

摘要/Abstract

摘要：

目的采用meta分析方法全面系统的评价中国人尿酸水平与急性缺血性脑卒中患者预后的关系。方法通过计算机系统检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、维普和万方数据库,收集有关中国人尿酸水平与急性缺血性脑卒中患者预后关系的病例对照研究,检索时限为从各数据库建库至2022年2月。采用STATA 16软件进行meta分析。结果共纳入13篇文献,共计11 046例研究对象,其中预后良好组8 016例,预后不良组3 030例。结果显示,预后良好组尿酸水平高于预后不良组[WMD=18.44 μmol/L,95%CI(3.20,33.68),P<0.05]。敏感性分析和发表偏倚检验结果表明本研究结果稳定、可靠。结论中国人尿酸水平与急性缺血性脑卒中患者的预后可能相关,并且预后良好的患者尿酸水平更高,提示尿酸水平较高的中国急性缺血性脑卒中患者可能预后功能更好。

关键词: 尿酸, 急性缺血性脑卒中, 预后, 中国, meta分析

Abstract:

Objective The meta analysis method was applied to comprehensively and systematically evaluate relations between uric acid and prognosis of Chinese patients with acute ischemic stroke.Methods PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP and Wanfang databases were searched by computer system to collect case-control studies on relation between the level of uric acid and prognosis of patients with acute ischemic stroke in Chinese from database establishment to February 2022. The Meta analysis was performed using STATA 16 software. Results Thirteen literatures representing a total of 11, 046 study subjects (n=8, 016 in the good prognosis group, and n=3 030 in the poor prognosis group) were included in the meta-analysis. The results showed that the uric acid level of patients in the good prognosis group was higher than that of poor prognosis group [WMD=18.44 μmol/L, 95%CI(3.20, 33.68), P<0.05]. The results of sensitivity analysis and publication bias test showed that the study results were stable and reliable.Conclusion The level of uric acid in Chinese may be related to the prognosis of patients with acute ischemic stroke, and the higher level of uric acid in Chinese patients may have a better prognosis.

Key words: uric acid, acute ischemic stroke, prognosis, China, Meta-analysis

中图分类号:

R743.33

王会新, 赵芳晴, 张馨妍, 侯晓雯. 中国人尿酸水平与急性缺血性脑卒中患者预后关系的meta分析[J]. 临床荟萃, 2022, 37(9): 785-790.

Wang Huixin, Zhao Fangqing, Zhang Xinyan, Hou Xiaowen. Relationship between uric acid and prognosis of Chinese patients with acute ischemic stroke: A meta analysis[J]. Clinical Focus, 2022, 37(9): 785-790.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2022.09.003

https://huicui.hebmu.edu.cn/CN/Y2022/V37/I9/785

图/表 5

参考文献 37

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第一作者	发表年份	平均年龄 (岁)	男性 (%)	样本量(例)		入院时尿酸 (μmol/L)		预后良好的定义标准
第一作者	发表年份	平均年龄 (岁)	男性 (%)	预后良好组	预后不良组	预后良好组	预后不良组	预后良好的定义标准
张毅^[10]	2020	60.2	66.5	125	78	227.1±19.4	268.6±50.2	出院时mRS≤2
郝美美^[11]	2019	62.4	61.8	232	189	322.0±87.4	281.3±86.2	出院时mRS≤2
张静^[12]	2019	63.2	71.2	236	167	343.9±102.7	311.2±110.7	90天mRS≤1
Zhang ^[13]	2016	64.6	66.3	196	107	319.9±93.9	317.6±83.6	90天mRS≤1
林友榆^[14]	2016	77.7	47.7	93	83	404.4±151.7	345.6±107.5	90天mRS≤1
李芳^[15]	2016	68.6	58.8	1 224	795	314.8±92.7	301.7±106.1	出院时mRS≤2
Liu^[16]	2015	63.9	63.4	112	104	331.5±103.4	277.7±105.6	90天mRS≤1
国钰梅^[17]	2016	62.3	39.5	3 081	359	301.8±93.6	295.5±100.9	出院时mRS≤2
谷新医^[18]	2014	69.5	81.6	1 965	566	321.8±94.8	313.8±100.8	出院时mRS≤2
刘宣^[19]	2013	64.1	61.9	46	38	341.1±112.1	272.1±88.0	90天mRS≤1
林绍鹏^[20]	2013	69.6	61.1	185	126	363.3±100.7	332.0±119.0	出院时mRS≤2
韩玉乐^[21]	2013	74.4	49.4	239	89	367.0±119.0	392.7±146.6	出院时mRS≤2
Zhang^[22]	2010	39.5	66.7	426	159	326.2±103.4	295.7±111.2	出院时mRS≤2

第一作者	发表年份	平均年龄 (岁)	男性 (%)	样本量(例)		入院时尿酸 (μmol/L)		预后良好的定义标准
第一作者	发表年份	平均年龄 (岁)	男性 (%)	预后良好组	预后不良组	预后良好组	预后不良组	预后良好的定义标准
张毅^[10]	2020	60.2	66.5	125	78	227.1±19.4	268.6±50.2	出院时mRS≤2
郝美美^[11]	2019	62.4	61.8	232	189	322.0±87.4	281.3±86.2	出院时mRS≤2
张静^[12]	2019	63.2	71.2	236	167	343.9±102.7	311.2±110.7	90天mRS≤1
Zhang ^[13]	2016	64.6	66.3	196	107	319.9±93.9	317.6±83.6	90天mRS≤1
林友榆^[14]	2016	77.7	47.7	93	83	404.4±151.7	345.6±107.5	90天mRS≤1
李芳^[15]	2016	68.6	58.8	1 224	795	314.8±92.7	301.7±106.1	出院时mRS≤2
Liu^[16]	2015	63.9	63.4	112	104	331.5±103.4	277.7±105.6	90天mRS≤1
国钰梅^[17]	2016	62.3	39.5	3 081	359	301.8±93.6	295.5±100.9	出院时mRS≤2
谷新医^[18]	2014	69.5	81.6	1 965	566	321.8±94.8	313.8±100.8	出院时mRS≤2
刘宣^[19]	2013	64.1	61.9	46	38	341.1±112.1	272.1±88.0	90天mRS≤1
林绍鹏^[20]	2013	69.6	61.1	185	126	363.3±100.7	332.0±119.0	出院时mRS≤2
韩玉乐^[21]	2013	74.4	49.4	239	89	367.0±119.0	392.7±146.6	出院时mRS≤2
Zhang^[22]	2010	39.5	66.7	426	159	326.2±103.4	295.7±111.2	出院时mRS≤2

第一作者	病例的定义和诊断是否恰当	病例是否具有代表性	对照组的选择方法	对照的描述是否充分	最重要的因素在两组中可比	其他重要的因素在两组中可比	暴露的确定方法	病例和对照的检测方法是否相同	两组无应答率相同	质量评分 (分)
张毅^[10]	√	√	√	×	×	×	√	√	√	6
郝美美^[11]	√	√	√	×	×	×	√	√	√	6
张静^[12]	√	√	√	√	×	×	√	√	√	7
Zhang^[13]	√	√	√	√	×	×	√	√	√	7
林友榆^[14]	√	√	√	√	√	×	√	√	√	8
李芳^[15]	√	√	√	√	√	×	√	√	√	8
Liu^[16]	√	√	√	×	×	×	√	√	√	6
国钰梅^[17]	√	√	√	×	√	×	√	√	√	7
谷新医^[18]	√	√	√	×	√	√	√	√	√	8
刘宣^[19]	√	√	√	√	×	×	√	√	√	7
林绍鹏^[20]	√	√	√	×	×	×	√	√	√	6
韩玉乐^[21]	√	√	√	×	×	×	√	√	√	6
Zhang^[22]	√	√	√	×	×	×	√	√	√	6

第一作者	病例的定义和诊断是否恰当	病例是否具有代表性	对照组的选择方法	对照的描述是否充分	最重要的因素在两组中可比	其他重要的因素在两组中可比	暴露的确定方法	病例和对照的检测方法是否相同	两组无应答率相同	质量评分 (分)
张毅^[10]	√	√	√	×	×	×	√	√	√	6
郝美美^[11]	√	√	√	×	×	×	√	√	√	6
张静^[12]	√	√	√	√	×	×	√	√	√	7
Zhang^[13]	√	√	√	√	×	×	√	√	√	7
林友榆^[14]	√	√	√	√	√	×	√	√	√	8
李芳^[15]	√	√	√	√	√	×	√	√	√	8
Liu^[16]	√	√	√	×	×	×	√	√	√	6
国钰梅^[17]	√	√	√	×	√	×	√	√	√	7
谷新医^[18]	√	√	√	×	√	√	√	√	√	8
刘宣^[19]	√	√	√	√	×	×	√	√	√	7
林绍鹏^[20]	√	√	√	×	×	×	√	√	√	6
韩玉乐^[21]	√	√	√	×	×	×	√	√	√	6
Zhang^[22]	√	√	√	×	×	×	√	√	√	6