文献类型：期刊文献

中文题名：多发性硬化患者死亡率及其原因的Meta分析

英文题名：Meta-analysis of mortality and its causes in multiple sclerosis patients

作者：吴瑞鹏[1];柴冰燕[1];胡小娟[1];谷成[1];任占宏[2];冯斌[1];高福林[1];张毅[1];颜克松[3]

第一作者：吴瑞鹏

机构：[1]甘肃省人民医院神经内科,730000;[2]甘肃渭源县中医院内科,730000;[3]甘肃中医药大学临床研究生院,730000

第一机构：甘肃省人民医院神经内科,730000

年份：2022

卷号：29

期号：4

起止页码：284

中文期刊名：中国神经免疫学和神经病学杂志

外文期刊名：Chinese Journal of Neuroimmunology and Neurology

收录：CSTPCD;;北大核心:【北大核心2020】；

基金：甘肃省科技计划项目(编号20JR5RA152);兰州市城关区科技计划项目(编号2018KJGG0032)。

语种：中文

中文关键词：多发性硬化;标准化死亡率;自杀率比;Meta分析

外文关键词：multiple sclerosis;standardized mortality ratio;suicide rate ratio;meta-analysis

摘要：目的采用Mata分析分析多发性硬化(multiple sclerosis,MS)患者的标准化死亡率(standardized mortality ratio,SMR)及死亡原因。方法从美国国立医学图书馆(Pubmed)、荷兰医学文摘(Embase)、Web of Science及the Cochrane图书馆检索关于MS患者SMR和SRR的原始研究。检索时限从建库到2020-02-29。采用Cochrane偏倚风险工具和纽卡斯尔-渥太华量表(the Newcastle-Ottawa Scale,NOS)评估了纳入研究的质量,使用Stata 12.0软件对MS患者SMR及SRR进行meta分析。采用敏感性分析检验Meta分析结果的稳定性,并通过漏斗图对称检测发表偏倚。结果本研究共纳入24篇文献,共153013例MS患者。总SMR和SRR分别为2.85〔95%CI(2.42~2.76),P=0.00〕和1.64〔95%CI(1.37~1.96),P=0.00〕。男性SMR为2.24〔95%CI(1.98~2.52),P=0.00〕,女性SMR为2.41〔95%CI(2.13~2.73),P=0.00〕。感染、呼吸系统疾病、心血管疾病和癌症引起MS患者死亡的SMR分别为4.40〔95%CI(2.97~6.51),P=0.00〕、2.13〔95%CI(1.30~3.49),P=0.00〕、1.49〔95%CI(1.27~1.74),P=0.00〕和1.15〔95%CI(0.98~1.50),P=0.00〕。自杀造成MS患者死亡的SRR为1.64〔95%CI(1.37~1.96),P=0.00〕。结论本研究中MS患者的SMR为2.85。在MS患者中,感染、呼吸系统疾病、心血管疾病及自杀是导致其死亡率增加的主要危险因素。
Objective Meta-analysis was performed on the standardized mortality ratio(SMR)of multiple sclerosis(MS)patients, and the different causes of death in MS patients.Methods Randomized controlled studies of SMR and SRR in MS patients were searched from the American National Library of Medicine(Pubmed),Dutch Medical Abstracts(Embase),Web of Science, and the Cochrane Library.The search time limit was from the establishment of the database to August, 31 th, 2019.Two investigators screened the literature according to the inclusion and exclusion criteria, and used the Cochrane risk of bias tool and the Newcastle-Ottawa Scale(NOS)to assess the quality of the included studies.The meta-analysis of SMR and SRR was performed using Stata 12.0 software;sensitivity analysis was used to test the stability of the Meta results, and the funnel chart was used to detect whether the publication bias was symmetric.Results Twenty-four studies involving 153 013 cases were included in this meta-analysis.The pooled SMR and SRR in MS patients were 2.85 [95%CI(2.42~2.76),P=0.00] and 1.64 [95%CI(1.37~1.96),P=0.00),respectively.All-cause SMR was 2.24 [95% CI(1.98~2.52),P=0.00] in males and 2.41[ 95% CI(2.13~2.73),P=0.00] in females.SMRs due to infection, respiratory diseases, cardiovascular diseases, and cancer were 4.40 [95%CI(2.97~6.51),P=0.00],2.13 [95%CI(1.30~3.49),P=0.00],1.49 [95%CI(1.27~1.74),P=0.00],and 1.15[95%CI(0.98~1.50),P=0.00).SRR due to suicide was 1.64[95%CI(1.37~1.96),P=0.00].Conclusions Standardized mortality ratio of MS patients was 2.85.In patients with MS,infections, respiratory diseases, cardiovascular diseases, and suicide are the main risk factors leading to increased mortality.