中国人群脑卒中发病危险因素meta分析

目的：运用meta分析方法综合评价中国人群脑卒中的发病危险因素。方法对2003年1月-2012年6月国内发表的有关中国人群脑卒中发病危险因素的研究文献进行meta分析。结果本研究共纳入8篇文献,累计病例5416例,对照10473例。危险因素中高血压病、糖尿病、心脏病、动脉粥样硬化、高脂血症、家族史、吸烟和饮酒的比值比（OR）均〉1,差异有统计学意义（P〈0.05）;性别和肥胖的95%可信区间均包含1,尚不能确定其与脑卒中的关系;高血压病的归因危险度最高（69.16%）。漏斗图分析：高血压病和糖尿病存在发表性偏倚;敏感性分析：家族史为脑卒中发病危险因素的稳定性较差。结论现有证据表明,高血压病、心脏病、糖尿病、高脂血症、动脉粥样硬化、吸烟、饮酒和家族史是中国人群脑卒中发病的危险因素。     

中国维持性血液透析患者并发认知障碍危险因素的meta分析

目的:系统评价中国维持性血液透析(MHD)患者并发认知障碍的危险因素。方法:检索PubMed、Embase、Cochrane Library、Web of Science、Wan Fang、CBM、CNKI和VIP数据库关于中国MHD患者并发认知障碍危险因素的文献,检索时限为建库至2022年2月26日,采用RevMan 5.4、Stata 15.1软件进行meta分析。结果:共纳入26篇文献,包含4228例MHD患者。meta分析结果显示高龄、受教育程度低、糖尿病、高血压、血红蛋白降低、超敏C反应蛋白升高、血清同型半胱氨酸升高、透析龄延长、低通道血流量、低血压事件是MHD患者并发认知障碍的危险因素。结论:MHD患者并发认知障碍的危险因素较多,医务人员应重点关注高危人群,尽早干预,减少认知障碍的发生。     

断指再植患者术后血管危象危险因素的meta分析

目的　系统评价断指再植术后血管危象的危险因素。方法　检索数据库万方、知网、维普、中国生物医学、Web of Science、PubMed、The Cochrane Library,检索时限为建库至2022年4月30日。由2名研究人员按照纳入和排除标准,独立进行文献筛选、资料提取、文献评价,运用Revman 5.3软件进行危险因素的meta分析,统计结果用比值比（OR）及95%置信区间（CI）表示,异质性检验当P≥0.1且I²<50%时采用固定效应模型,P<0.1和/或I²≥50%,采用随机效应模型进行meta分析。结果　最终纳入9篇文献,共1 728例患者,发生血管危象303例,血管危象发生率为21.26%。meta分析显示,性别（女性）（OR=3.73,95%CI 2.04～6.82,P<0.000 01）、年龄<12岁（OR=4.71,95%CI 3.41～6.50,P<0.000 01）、吸烟史（OR=4.06,95%CI 3.08～5.35,P<0.000 01）、缺血时间>10 h（OR=3.04,95%CI 1.52～6.07,P=0.002）、伤因（挤压撕脱伤）（OR=4.09,95%CI 2.89～5.78,P<0.000 01）、离断平面（末节离断）（OR=4.10,95%CI 3.03～5.54,P<0.000 01）是断指再植术后血管危象的危险因素。结论　断指再植术后血管危象发生率较高,应针对女性、低龄、有吸烟史、缺血时间长、挤压撕脱伤、末节离断等再植患者采取有针对性的预防措施,以减少血管危象的发生,提高断指再植的成活率。     

烟雾病行血运重建术患者发生脑卒中的危险因素meta分析

目的 系统评价烟雾病行血运重建术患者发生脑卒中的危险因素。方法 检索中国知网、万方、维普、Cochrane、PubMed、Embase数据库,筛选关于烟雾病行血运重建术患者发生脑卒中的影响因素的文献,检索时间从建库至2022年12月31日。文献检索、文献筛选、质量评价和数据收集由2名研究者独立进行,选用Stata 16.0软件进行meta分析。结果 共纳入16篇文献,共计2678例患者。meta分析结果显示：大脑后动脉受累[OR=3.08,95%CI(2.23,4.26)]、合并糖尿病[OR=4.84,95%CI(2.22,10.55)]、吸烟[OR=8.81,95%CI(2.66,29.14)]、高铃木分期[OR=2.05,95%CI(1.35,3.11)]、既往短暂性脑缺血发作（TIA）发作[OR=2.92,95%CI(1.78,4.80)]、既往脑卒中发作[OR=4.90,95%CI(2.75,8.73)]、脑血管储备不良[OR=2.23,95%CI(1.56,3.18)与烟雾病行血运重建术患者发生脑卒中相关。结论 大脑后动脉受累、合并糖尿病、吸烟、高铃木分期、既往TIA发作、既...     

危重患者肠内营养喂养不耐受危险因素的meta分析

目的 分析危重患者肠内营养(EN)期间喂养不耐受的危险因素,为保障患者顺利摄入EN提供依据.方法 计算机检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、中国生物医学文献数据库、万方、维普等数据库关于EN喂养不耐受危险因素的文献,检索时间为2010年1月至2020...     

司库奇尤单抗治疗银屑病关节炎有效性和安全性的meta分析

目的 系统评价司库奇尤单抗治疗银屑病关节炎(psoriatic arthritis,PA)的有效性与安全性。方法 检索英文数据库(PubMed、MEDLINE、Embase、Cochrance Library)及中文数据库(中国知网、维普数据库、万方数据库)中司库奇尤单抗治疗PA的相关文献,检索时间为2000年1月至2020年12月。对符合纳入标准的文献进行质量评价后,应用Revman 5.4软件进行meta分析。结果 共纳入5篇随机对照研究文献,涉及2 455例PA患者。Meta分析结果显示,与安慰组相比,司库奇尤单抗治疗组显著改善患者的美国风湿病学会(American College of Rheumatology,ACR)病情缓解20%[相对危险度(odds ratio,OR)=4.40,95%置信区间(confidence interval,CI)(3.79,5.11),P<0.000 01]、ACR50[OR=5.84,95%CI(4.82,7.07),P<0.000 01]、ACR70[OR=7.98,95%CI(5.64,11.27),P<0.000 0...     

手足口病发病的危险因素分析

目的探究分析手足口病发病的危险因素。方法选取近3年在我院确诊手足口病及非感染性疾病就诊的患儿150例,对照组为非感染性疾病就诊的患儿75例,试验组确诊手足口病患儿75例,运用调查问卷的形式对患儿家长进行调查,观察并比较两组患儿的职业、卫生条件、卫生习惯、是否曾患手足口病、家长手足口病预防知识、近1周是否与其他儿童共用玩具等情况。结果试验组患儿散居(65.33%)、卫生条件不良(66.67%)、卫生习惯不良(68.00%)、曾患手足口病(26.67%)、家长手足口病预防知识缺乏(38.67%)、近1周与其他儿童共用玩具(76.00%)明显高于对照组患儿散居(32.00%)、卫生条件不良(40.00%)、卫生习惯不良(34.67%)、曾患手足口病(1.00%)、家长手足口病预防知识缺乏(12.00%)、近1周与其他儿童共用玩具(44.00%),两组有显著性差异,统计学上有意义(P<0.05)。结论对比分析手足口病发病的危险因素,发现儿童发生手足口病主要受卫生情况、家长手足口病预防知识掌握等情况的影响。     

儿童支气管哮喘发病的危险因素分析

目的探讨儿童支气管哮喘发病的危险因素。方法选取就诊于我院的儿童支气管患儿176例纳入哮喘组,同时选取同期正常儿童176例纳入正常组。首先采用SPSS17.0作单因素分析可能引起儿童支气管哮喘的发病因素17项,筛选出P0.05的单因素作Logistic回归模型的自变量,作多因素分析,得出影响儿童支气管哮喘的高危因素。结果经单因素分析结果显示,影响儿童支气管哮喘的单因素共有10项,且P0.05,与正常组对比具有统计学意义。Logistic多因素回归分析结果显示,影响儿童支气管哮喘的高危因素为呼吸道感染、家族哮喘史、未补充鱼肝油、家人吸烟,且母乳喂养是哮喘的保护因素。结论积极预防儿童哮喘的高危因素,提高保护意识,对于预防和控制儿童哮喘具有重要意义。     

结肠癌发病的危险因素logistic回归分析

目的探讨结肠癌的发病危险因素。方法对89例结肠癌患者和89例非糖尿病患者进行1:1病例对照研究,采用多因素非条件logistic回归模式分析结肠癌的发病的危险因素。结果 10次食用肉食/周,常处于坐位,一级亲属有恶性肿瘤病史,差异有明显的统计学意义(P>0.05)。结论 10次食用肉食/周,常处于坐位,一级亲属有恶性肿瘤病史是结肠癌发病的危险因素。     

社区居民第一秒用力呼气容积下降的危险因素分析

目的探讨在一般人群中影响第1秒用力呼气容积(FEV1)下降速度的相关因素。方法在山西省太原市晋源区社区卫生服务中心招募35岁以上居民进行问卷调查、体格检查、肺功能筛查,随访1.5年观察FEV1下降速度及其可能的危险因素。结果纳入研究对象共436人,其中男性249人,女性187人,平均年龄(54±10)岁。18例调查者FEV1无明显下降,418例调查者肺功能均出现了FEV1下降趋势,FEV1的年均下降量(38±11)ml;初筛慢性阻塞性肺疾病患者的FEV1年均下降量约(48±10)ml。吸烟者年均FEV1下降量(49±13)ml,不吸烟者(31±9)ml,两者之间差异有统计学意义(P<0.05)。Logistic多因素回归分析提示吸烟、体质量指数、慢性咳嗽、糖尿病、心血管疾病是影响FEV1下降的主要危险因素,其中吸烟是加速FEV1下降的独立危险因素。结论在社区居民中定期监测肺功能不仅利于慢性阻塞性肺疾病的早防早治,同时有利于预测心血管系统疾病、糖尿病的发展趋势。     

Risk factors for medication misadventure among residents in sheltered housing complexes

AIM: To identify risk factors for unplanned hospitalizations among residents of sheltered housing complexes (SHCs). METHODS: Medication-related risk factors for health outcomes among residents of SHCs in Aberdeen (n = 1137) were assessed using a postal questionnaire. Predictors of unplanned hospitalization/emergency department (ED) visit were identified using logistic regression. RESULTS: Of the 695 (61.1%) responses received, 645 were from residents (mean age 78.2 years) using prescribed medications. One or more risk factors for medication-related problems was seen in 467 (72.4%) respondents; 488 (75.7%) were using medications with high potential for adverse drug reactions (ADRs) in the elderly. Unplanned hospitalizations/ED visits (n = 230) were found to be associated with use of drugs of narrow therapeutic index [P < 0.001; odds ratio (OR) 2.98, 95% confidence interval (CI) 1.69, 5.28]; use of five or more different medications (P = 0.001; OR 2.10, 95% CI 1.34, 3.31); and greater disability (Townsend score) (P = 0.005; OR 1.06, 95% CI 1.02, 1.11). CONCLUSION: Residents of SHCs using drugs of narrow therapeutic index, using five or more different medications, and with greater disability warrant periodic monitoring.     

寻常型银屑病血热证患者免疫血清学标志物的系统评价

目的：系统评价寻常型银屑病血热证患者免疫血清学标志物γ-干扰素（interferon-γ, IFN-γ）、白介素（interleukin, IL）-4、IL-17、IL-23、IL-6、α-肿瘤坏死因子（tumor necrosis factor-α, TNF-α）和IL-10水平的变化。方法：完整检索7个数据库中的近30年相关文献,纳入17篇文献,共包括768例受试者（443例寻常型银屑病血热证患者和325例健康对照者）。评价被纳入文献的研究质量并提取有效数据,然后采用随机效应模型合并受试组和对照组受试者的免疫血清学标志物水平效应量。结果：总效应量分析结果显示,受试组患者的血清IFN-γ水平（均数差24.90 pg/ml,95% CI：12.36~37.43）、IL-17水平（均数差28.92 pg/ml,95% CI：17.44~40.40）、IL-23水平（均数差310.60 pg/ml,95% CI：4.96~616.24）和TNF-α水平（均数差19.84 pg/ml,95% CI：13.80~25.87）显著高于对照组, IL-4水平（均数差-13.5 pg/ml,95% CI：-17.74~-9.26）和IL-10水平（均数差-10.33 pg/ml,95% CI：-12.03~-8.63）显著低于对照组,IL-6水平没有显著变化。结论：寻常型银屑病血热证患者的血清IFN-γ、IL-17、IL-23和TNF-α水平显著升高,而IL-4和IL-10水平显著降低。该结论尚需得到高质量、大样本量临床研究的进一步证实。     

Risk of gastrointestinal complications in breast cancer patients treated with neratinib: a meta-analysis

Backgrounds: Neratinib is a potent EGFR/HER2 kinase inhibitor. Gastrointestinal complications (i.e. diarrhea, vomiting and nausea) are the most common adverse events. In this study, we aimed to investigate (1) the overall incidence and relative risk (RR) of diarrhea, vomiting and nausea and (2) whether combination neratinib therapy increased the incidence of gastrointestinal complications versus neratinib alone.

Methods: Relevant studies were identified from the PubMed database, from abstracts presented at the American Society of Clinical Oncology annual conference and from the Web of Science database. Incidences, RRs, and 95% confidence intervals (CIs) were calculated.

Results: The incidences of all-grade diarrhea, vomiting and nausea in the neratinib groups were 89% (95% CI = 77–95%), 31% (95% CI = 25–37%) and 44% (95% CI = 33–55%), respectively. The neratinib arms significantly increased the risk of diarrhea and vomiting in comparison with the control groups (diarrhea: all-grade, RR = 2.06, 95% CI = 1.38–3.08, P = 0.0004; grade 3/4, RR = 8.77, 95% CI = 2.91–26.40, P = 0.0001; vomiting: all-grade, RR = 2.02, 95% CI = 1.10–3.71, P = 0.02; grade 3/4, RR = 7.10, 95% CI = 3.33–15.15, P < 0.00001).

Conclusions: Our meta-analysis demonstrates that the neratinib arms are associated with a significantly increased risk of diarrhea and vomiting.     

Risk of hypertension with regorafenib in cancer patients: a systematic review and meta-analysis

Background

Regorafenib is a novel multikinase inhibitor approved for use in metastatic colorectal cancer (mCRC) and locally advanced gastrointestinal stromal tumors (GISTs). Hypertension is one of the major adverse events of this agent, but to date the incidence and risk of hypertension with regorafenib have not been systematically investigated. We have conducted a systematic review and meta-analysis of published clinical trials to determine its overall incidence and risk.

Methods

PubMed, Web of Science and abstracts presented at the American Society of Clinical Oncology annual meetings were searched to identify relevant studies published up to September 9, 2013. Eligible studies were prospective phase II or III clinical trials using regorafenib in cancer patients with data on hypertension available. The incidence and relative risk (RR) of hypertension were calculated using a random-effects model.

Results

Data from a total of 1,069 patients (regorafenib n?=?750; controls n?=?319) from five clinical trials were included for analysis. The overall incidence of all-grade and high-grade hypertension were 44.4 % [95 % confidence interval (CI) 30.8–59.0 %) and 12.5 % (95 % CI 5.2–27.1 %), respectively. The use of regorafenib in cancer patients was associated with a significantly increased risk of all-grade (RR 3.76, 95 % CI 2.35–5.99) and high-grade (RR, 8.39, 95 % CI 3.10–22.71) hypertension. The risk might vary with tumor types (P?=?0.000).

Conclusions

Patients with cancer receiving regorafenib have a significantly higher risk of developing hypertension. Close monitoring and appropriate management of this hypertension are strongly recommended.     

中国癌症患者癌因性疲乏影响因素的meta分析

目的:探讨中国癌症患者癌因性疲乏(CRF)的影响因素.方法:计算机检索数据库PubMed、Embase、Web of Science及CNKI、CBM、Wan Fang、VIP,搜索建库至2020年3月31日的有关中国癌症患者CRF影响因素的相关文献,使用RevMan 5.3软件进行分析.结果:本研究共纳入21篇文献,...     

Risk of elevated transaminases in cancer patients treated with immune checkpoint inhibitors: a meta-analysis

Background: This meta-analysis has been conducted to determine the risk of elevated transaminases associated with immune checkpoint inhibitors use in patients with cancer.

Methods: Studies eligible for our analysis included randomized Phase II and III trials of patients with cancer on ipilimumab, nivolumab, pembrolizumab, tremelimumab and pidilizumab, which describe events of elevated transaminases [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)].

Results: Initial database search revealed 210 relevant citations. After excluding noneligible studies, 10 trials were considered eligible for the quantitative synthesis. The RR of all-grade elevated ALT and AST was 2.36 (95% CI 1.20–4.66; p = 0.01) and 1.53 (95% CI 0.73–3.22; p = 0.26), respectively, whereas for high-grade elevated ALT and AST, it was 11.27 (95% CI 5.38–23.63; p < 0.0001) and 4.9 (95% CI 2.97–8.09; p < 0.0001), respectively.

Conclusions: Our study has shown that the use of immune checkpoint inhibitors has a causal relationship to an increased risk of high-grade elevated ALT and AST. Clinicians using these agents should be attentive of this risk.     

北京地区高血压患者用药依从性及影响因素调查与研究

目的：调查北京地区高血压患者药物治疗依从性及达标率现状,分析依从性的主要影响因素和药师提供药学服务后患者依从性的改善情况,以期为后续制定社区药学服务干预措施提供数据支持。方法：设计依从性及影响因素调查问卷,药师通过面对面访谈的形式开展前瞻性调研并提供药学服务,跟踪随访3个月,比较依从性变化。结果：共调研高血压患者1382人,药学服务前后依从性差的患者例数为447（32.34%）和356（25.76%）,两者比较有统计学差异（P<0.05）;多因素Logistics回归显示年龄、吸烟、饮酒、自行经验购药、体育锻炼和生活方式是依从性的独立影响因素（P<0.05）。结论：我国高血压患者的药物治疗依从性现状仍然不太理想,药学服务能显著提高患者的用药依从性。针对依从性危险因素,今后药学干预措施应侧重于高血压用药知识宣教、加强体育锻炼、戒烟宣传及健康生活方式指导。