稳定期COPD患者认知障碍的Meta分析

目的 系统评价稳定期COPD患者认知障碍.方法 通过检索Cochrane Library、PubMed、中国学术期刊全文数据库、维普数据库、中国生物医学文献光盘数据库、万方数据库,全面收集通过简易精神状态检查(MMSE)量表评估稳定期COPD患者的认知功能障碍的病例对照研究.按照纳入、排除标准纳入文献后提取有效数据进行Meta分析.结果 最终纳入9篇文献,其中中文4篇,英文5篇,包括520例患者和381例对照者.Meta分析结果显示:稳定期COPD组与正常对照组相比,MMSE评分明显降低,差异有统计学意义(SMD=-0.973,95％CI:-1.565～-0.380,P＜0.01).累积Meta分析结果显示,稳定期COPD患者与认知功能障碍之间始终有相关性.对单个研究的敏感性分析提示,单项研究剔除后对总体结果影响不大.本研究通过Begg's检验和Egger's检验进行发表偏倚的识别和评估,结果不存在发表偏倚(P值均＞0.05).结论 稳定期COPD患者存在明显的认知障碍,但仍需更多高质量、大规模、多中心的临床随机对照研究加以证实.

Meta analysis of cognitive dysfunction in patients with stable chronic obstructive pulmonary disease

Objective To evaluate the cognitive dysfunction in patients with stable chronic obstructive pulmonary disease (COPD).Methods Through searching the Cochrane Library,PubMed,China academic journals full text database,VIP database,Chinese biomedical literature CD-ROM Database,Wan fang database,and comprehensively collecting the case control study of cognitive impairment in patients with stable COPD by a simple mental state examination (MMSE) scale.According to the inclusion and exclusion criteria,the effective data were extracted to Meta-analyzed.Results Finally,we included 9 articles,including 4 Chinese and 5 English languages,including 520 patients and 381 control subjects.Meta analysis showed:compared with the normal control group,the MMSE score was significantly lower in the stable COPD group than in the normal control group,and there was statistical significance (SMD=-0.973,95 ％ CI:-1.565--0.380,P ＜ 0.01).Cumulative Meta analysis showed that there was a correlation between patients with stable COPD and cognitive dysfunction.The sensitivity analysis suggests that there had little effect on the overall outcome after the removal a single study.In this study,the identification and assessment of publication bias was performed by Beggts test and Egger's,and there was no publication bias (all P ＞0.05).Conclusions There were obvious cognitive impairment in patients with stable COPD,but still need more high-quality,large-scale,multi center clinical randomized controlled study to confirm.