急性脑卒中患者大脑病变部位与卒中后抑郁发生关系的Meta分析

J4 ›› 2012, Vol. 38 ›› Issue (3): 532-536.doi:

急性脑卒中患者大脑病变部位与卒中后抑郁发生关系的Meta分析

邓景元¹|刘亚民²|吕雅丽³|杨林²|冯骏²

(1.西安交通大学医学院第一附属医院康复医学科|陕西西安 710061；2. 西安交通大学医学院第一附属医院脑血管科|陕西西安 710061；3.陕西省西安市第九医院老年病二科|陕西西安 710054)

收稿日期:2011-11-24 出版日期:2012-05-28 发布日期:2012-05-28
通讯作者: 冯骏(Tel: 029-85324045， E-mail：fjcccp@sina.com) E-mail:fjcccp@sina.com
作者简介:邓景元（1968-）|男|陕西省西安市人|主治医师|医学学士|主要从事脑血管病治疗的研究。
基金资助:
陕西省科技攻关项目资助课题（2006K13-G7）

Meta-analysis on association between |brain lesion location |and poststroke depression in patients with acute stroke

DENG Jing-yuan¹,LIU Ya-min²,LV Ya-li³,YANG Lin²,FENG Jun²

(1. Department of Rehabilitation Medicine,First Affiliated Hospital|School of Medical Sciences,Xi’an Jiaotong University,Xi’an 710061,China；2. Department of Cerebral Vessels,First Affiliated Hospital,School of Medical Sciences,Xi’an Jiaotong University,Xi’an 710061,China；3.Second |Department |of Geriatrics|Nineth Hospital of Xi’an City,Xi’an 710054,China)

Received:2011-11-24 Online:2012-05-28 Published:2012-05-28

摘要/Abstract

摘要：

［摘要］目的：利用Meta分析方法评价我国人群急性脑卒中患者大脑病变部位与卒中后抑郁（PSD）发生的关系，为探讨PSD发生机制提供循证医学证据。方法：计算机检索Pubmed、CNKI、维普及万方数据库，搜集2000年1月—2011年11月PSD与卒中病变相关的文献，纳入符合标准的文献，并对其进行评价和数据提取。应用ReviewManager 5.1软件对各研究中的原始数据进行统计，采用固定效应模型或随机效应模型进行合并效应量分析，评估发表偏倚并进行敏感性分析。结果：共纳入22篇文献，共计3 545名研究对象，其中PSD患者1 493例，非PSD患者2 052例。PSD与大脑不同病变部位关系的合并OR值及95%CI分别为：左半球1.60(1.39~1.83)(P<0.001)、大脑前部2.76(1.60~4.75) (P<0.001)、额叶2.11(1.00~4.45) (P=0.05)和皮质层2.22(0.74~6.62) (P=0.15)。卒中后急性期患者，病变部位在大脑左半球者发生PSD的危险性是病变部位在右半球者的1.60倍，病变部位为大脑前部发生PSD的危险性是病变部位为后部的2.76倍。结论：急性脑卒中患者病变部位在大脑左半球和大脑前部是发生PSD的危险性因素。

关键词: 脑卒中后抑郁；病变部位；Meta分析

Abstract:

Abstract:Objective To evaluate the association between brain lesion location and occurrence of poststroke depression patients (PSD) with acute stroke from Chinese people with Meta-analysis,and to provide evidence to explore mechanism of PSD.Methods Pubmed,CNKI,VIP and Wanfang databases were searched by computer to find literatures focused on associations between lesion location and PSD from January 2000 to November 2011.Those met criterion were included in the study and evaluated.The data in the articles was extracted at the same time.ReviewManager 5.1 software was performed to analyze the data. Fix effect model and random effect model were used to calculate combined effects.Publish bias was evaluated and the sensitivity analysis was performed.Results Twenty-two articles were included in the study finally.In all,3 545 subjects included,which contained 1 493 PSD patients and 2 052 non-PSD persons.Combined OR and its 95% confidence interval which were used to evaluate associations between PSD and different lesion location were as follows: left hemisphere 1.60(1.39-1.83) (P<0.001),front of brain 2.76(1.60-4.75) (P<0.001),frontal lobe 2.11(1.00-4.45) (P=0.05),and cortex 2.22(0.74-6.62) (P=0.15).Among acute stroke patients,those who suffered with their left hemisphere had 1.6 times higher risk to be PSD of those with right hemisphere injure;the patients who suffered with their front of brain had 2.76 times higher risk to be PSD of those with back of brain injure.Conclusion The lesion places which located in left hemisphere and front of brain are the risk factors for PSD.

Key words: poststroke depression;lesion location;Meta-analysis

中图分类号:

R749.1

邓景元|刘亚民|吕雅丽|杨林|冯骏 . 急性脑卒中患者大脑病变部位与卒中后抑郁发生关系的Meta分析[J]. J4, 2012, 38(3): 532-536.

DENG Jing-yuan,LIU Ya-min,LV Ya-li,YANG Lin,FENG Jun. Meta-analysis on association between |brain lesion location |and poststroke depression in patients with acute stroke[J]. J4, 2012, 38(3): 532-536.