双上肢收缩压差与心血管疾病相关性的Meta分析

摘要

目的：通过Meta分析来探讨双上肢收缩压差值（ IADSBP）与心血管疾病的相关性。方法计算机检索The Cochrane Library、PubMed、Medline、EMbase、中国知网及万方数据库，检索时间截止至2014年9月30日，查找包含双上肢血压差值与心血管疾病相关数据的队列研究、病例对照研究及观察性研究，阅读并严格按照纳入标准筛选，提取数据，通过Revman5.3软件进行Meta分析。结果共纳入7篇文献，8个横断面观察性研究，均为英文文献，共5263例患者，所纳入研究根据IADSBP≥15 mmHg，＜15 mmHg分为两组， Meta分析显示： IADSBP≥15 mmHg组与＜15 mmHg组冠心病发生率无统计学差异（RR=1.03，95%CI：0.67~1.58，P=0.88）。同步测量亚组分析（RR=0.87，95%CI：0.59~1.30， P=0.51）及非同步测量亚组分析（RR=1.13，95%CI：0.55~2.31，P=0.73），其结果亦提示IADSBP≥15 mmHg与＜15 mmHg组冠心病发生率无统计学差异。结论 IADSBP≥15 mmHg与心血管疾病发病无明显相关性，暂不能较好的作为冠心病的危险预测因素。%Objective To investigate the correlation between inter-arm difference in systolic blood pressure (IADSBP) and cardiovascular diseases through Meta-analysis.Methods The databases of Cochrane Library, PubMed, Medline, EMbase, CNKI and WanFang Database were retrieved with computer (until Sept. 30, 2014) for searching the cohort studies, case controlled studies and observation studies related to the correlation between IADSBP and cardiovascular diseases. All documents were read and screened strictly according to exclusion criteria. The data were extracted and given a Meta-analysis by using Revman5.3 software.Results There were totally 7 documents and 8 cross-section observation studies included (all in English) involving 5263 cases. All included studies were divided into group 1 (IADSBP≥15 mmHg) and group 2 (IADSBP<15 mmHg). The Meta-analysis showed that incidence of chronic heart disease (CHD) had no statistical difference between 2 groups (RR=1.03, 95%CI: 0.67~1.58, P=0.88). The simultaneous detection in subgroups showed (RR=0.87, 95%CI: 0.59~1.30,P=0.51) and those of non-simultaneous detection showed (RR=1.13, 95%CI: 0.55~2.31,P=0.73), and the results also indicated that CHD incidence had no statistical difference between 2 groups.Conclusion IADSBP (≥15 mmHg) is not significantly correlated to cardiovascular diseases, so it cannot be taken as risk predictive factor of CHD.