中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (10): 794-798.doi: 10.3969/j.issn.1671-4091.2023.10.017

• 护理研究 • 上一篇    

维持性血液透析患者发生缺血性卒中影响因素的Meta分析

王冰洁   梁 琪   陈 宇   张春梅   

  1. 301617 天津，1天津中医药大学护理学院
  • 收稿日期:2023-07-03 修回日期:2023-08-16 出版日期:2023-10-12 发布日期:2023-09-28
  • 通讯作者: 张春梅 E-mail:43318222@qq.com
  • 基金资助:
    基金项目：天津市研究生科研创新项目(2022SKY239)；天津中医药大学研究生科研创新项目(YJSKC-20221033)

Risk factors for ischemic stroke in maintenance hemodialysis patients: a meta-analysis

WANG Bing-jie, LIANG Qi, CHEN Yu, ZHANG Chun-mei   

  1. School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
  • Received:2023-07-03 Revised:2023-08-16 Online:2023-10-12 Published:2023-09-28
  • Contact: 301617 天津，1天津中医药大学护理学院 E-mail:43318222@qq.com

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摘要： 目的 系统分析维持性血液透析(maintenance haemodialysis,MHD)患者发生缺血性卒中(ischemic stroke,IS)的影响因素。 方法 检索CNKI、Wanfangdata、VIP、CBM、PubMed、EMbase、The Cochrane Library、Web of science数据库的相关文献，检索时间均从建库至2023年3月。由2名研究者独立筛选文献、提取资料，并对文献进行质量评价，采用RevMan 5.3软件进行Meta分析。 结果 共纳入14篇队列研究，样本量6876例，文献质量均为高质量。14项研究共发现6种危险因素，1种保护因素，IS病史和糖尿病肾病对MHD患者发生IS的影响尚无定论。Meta分析结果显示：年龄(HR =1.04,95% CI：1.03～1.06,P＜0.001)、糖尿病(HR =1.88,95% CI：1.38～2.58,P＜0.001)、心房颤动病史(HR =2.71,95% CI:1.73～4.27,P＜0.001)、脑血管病史(HR =4.97,95% CI：3.16～7.82,P＜0.001)、氨基末端脑钠肽前体(HR =4.43,95% CI：1.66～11.80,P =0.003)、血小板计数(HR =1.01,95% CI：1.00～1.02,P=0.001)、血清磷酸盐(HR=0.57,95% CI：0.44～0.74,P＜0.001)是MHD患者发生IS的影响因素。 结论 医护人员可依据上述因素识别MHD合并IS高危人群并进行早期干预，以提高MHD患者生活质量。

关键词: 维持性血液透析, 缺血性卒中, 影响因素, 队列研究

Abstract: Objective To systematically summarise the factors influencing the occurrence of ischaemic stroke (IS) in maintenance haemodialysis (MHD) patients. Methods Relevant literature from CNKI, Wanfangdata, VIP, CBM, PubMed, EMbase, The Cochrane Library, and web of science databases were searched, all from the time of database creation to February 2023. Two investigators independently screened the literature, extracted information, and evaluated the literature for quality, and Meta-analysis was performed using RevMan 5.3 software. Results A total of 14 cohort studies with a sample size of 6,876 cases were included, and the quality of the literature was high. 14 studies identified a total of 6 risk factors and 1 protective factor, and the effect of history of IS and diabetic nephropathy on the development of IS in MHD patients was inconclusive. meta-analysis results showed that age (HR=1.04, 95% CI:1.03 to 1.06), diabetes (HR= 1.88, 95% CI:1.38 to 2.58), history of atrial fibrillation (HR=2.71, 95% CI:1.73 to 4.27), history of cerebrovascular disease (HR=4.97, 95% CI:3.16 to 7.82), NT-proBNP (HR=4.43, 95% CI:1.66 to 11.80), serum phosphate (HR= 0.57, 95%CI:0.44 to 0.74), and platelet count (HR=1.01, 95%CI:1.00 to 1.02) were influential factors in the development of IS in MHD patients. Conclusions Healthcare professionals can identify people at risk for IS in MHD patients based on these factors and intervene early to improve the quality of life of MHD patients.

Key words: Maintenance hemodialysis, Ischemic stroke, Risk factor, Cohort study

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