分支动脉粥样硬化病和腔隙性脑梗死临床差异met a分析

摘要

目的比较分支动脉粥样硬化病（branch atheromatous disease，BAD）和腔隙性脑梗死（lacunar infarction，LI）之间的临床差异。　　方法检索国内外数据库，查找分支动脉粥样硬化病和腔隙性脑梗死相关文献，使用RevMan 5.2进行数据处理，对文献进行meta分析。　　结果在中国人群中BAD患者年龄小于LI患者（MD -2.70，95%CI -4.29～-1.11，P＜0.01）；在日本人群中BAD患者年龄大于LI患者（MD 2.58，95%CI 0.75～4.41，P＜0.01）。BAD患者的高脂血症患病率更高（OR 1.26，95%CI 1.03～1.55，P=0.03）。行敏感性分析后发现，BAD患者糖尿病（OR 1.28，　　95%CI 1.02～1.61，P=0.03）、入院时美国国立卫生研究院卒中量表（national institutes of health stroke scale，NIHSS）评分（MD 0.76，95%CI 0.50～1.02，P＜0.01）和预后情况（OR 0.54，95%CI 0.38～0.77， P＜0.01）在BAD和LI患者之间存在差异性显著。　　结论 BAD患者糖尿病、高脂血症发病率显著高于LI患者，其早期神经功能和预后情况均差于LI患者。中国人群中BAD和LI患者的年龄分布特征与和日本人群相反。%Objective To make a further comparison for the clinical differences between branch atheromatous disease(BAD) and lacunar infarction(LI). Methods We searched the Chinese and foreign language databases for relevant studies. Statistical analysis were performed by RevMan 5.2 software. Results In China, BAD patients were younger than LI patients(MD-2.70, 95%CI-4.29~-1.11, P<0.01); In Japan, BAD patients were older than LI patients(MD 2.58, 95%CI 0.75~4.41,P<0.01). Hyperlipidaemia affected more BAD patients(OR 1.26, 95%CI 1.03~1.55,P=0.03). After the sensitivity analysis, diabetes mellitus(OR 1.28, 95%CI 1.02~1.61,P=0.03), initial national institutes of health stroke scale(NIHSS score)(MD 0.76, 95%CI 0.50~1.02,P<0.01) and prognosis (OR 0.54, 95%CI 0.38~0.77,P<0.01) showed signiifcant differences between BAD and LI. Conclusion Hyperlipidaemia and diabetes mellitus affected more BAD patients, compared to LI patients. The nerve functional and prognosis of BAD patients were worse than LI patients. The characteristic of age distribution in Chinese BAD and LI patients was contrary to Japanese.