1980-2011年中国社区55岁及以上人群中血管性痴呆流行病学的Meta分析

摘要

目的探讨1980-2011年中国55岁以上人群中血管性痴呆（vasculardementia，VD）的发病率、患病率和死亡率。　　方法通过系统检索《中国生物医学文献数据库》（ChineseBioMedicalLiteratureDatabase，CBM）、《中国期刊全文数据库》（ChineseJournalFul-textDatabase，CNKI）、《中国科技期刊数据库》（ChineseScience-TechnologyPeriodicalDatabase，VIP）、万方数据库、PubMed、荷兰医学文摘数据库（ElsevierScienceBibliographicDatabases，EMBASE）、Cochrane图书馆等中英文数据库，纳入1980-2011年正式发表的有关中国VD流行病学的调查研究，提取VD流行病学原始数据，根据异质性检验结果，采用随机效应模型对原始数据进行合并分析。　　结果研究共纳入62篇文献。中国社区55岁以上人群中VD患病率、发病率和死亡率的合并值分别为0.8%[95%可信区间（confidenceinterval，CI）0.7%～0.9%]、0.27（95%CI0.20～0.34）/100人·年和14.6（95%CI6.7～22.4）/100人·年。1980-2011年间VD的患病率缓慢上升，中间略有波动。VD患病率北方高于南方、城市高于农村（1.3%vs0.9%）。VD的患病率、发病率都随年龄增大而升高（60～64岁至80岁以上年龄人群VD患病率从0.2%升至2.4%、发病率从0.14/100人·年升至0.57/100人·年）、男性略高于女性（0.8%vs0.7%、0.29/100人·年vs0.19/100人·年）、文盲高于小学和初中以上者（分别为1.5%、0.8%、0.6%；0.26/100人·年、0.23/100人·年、0.15/100人·年）。　　结论1980年至今，VD患病率缓慢上升，有明显的南北和城乡差异，年龄、性别、教育程度可能影响VD的患病率和发病率。%Objective To analyze the incidence, prevalence and mortality of vascular dementia (VD) among the population aged 55 years and older in mainland China from 1980 to 2011. Methods Epidemiological investigations on VD published in journals and covering the period from 1980 to 2011 were identified manually and online by using the Chinese BioMedical Literature Database (CBM), the Chinese Journal Full-text Database (CNKI), the Chinese Science-Technology Periodical Database (VIP) and Wanfang Database. Those reported in English journals were identified using PubMed, Elsevier Science Bibliographic Databases (EMBASE) and the Cochrane library. The random effects model was employed according to statistical test of homogeneity. Results Sixty-two studies were included, the statistical information of which was collected for systematic analysis. The pooled prevalence, incidence and mortality of VD was 0.8% (95%[confidence interval, CI] 0.7%~0.9%), 0.27 (95%CI 0.20~0.34)/100 person-year and 14.6 (95%CI 6.7~22.4)/100 person-year. The prevalence of VD was slowly rising between 1980 and 2011 and higher in northern China and urban. There was a higher prevalence of VD in the population who was older, male and illiterate and the same for its incidence. Conclusion The prevalence of VD has slowly risen since 1980 and is obviously different between the North and South, urban and rural district. The prevalence and incidence of VD may be affected by age, sex and education.