摘要
目的探讨心理应激与传统压力应激诱发稳定型冠状动脉粥样硬化性心脏病(冠心病)患者心肌缺血的发生率及性别差异。方法在万方医学网、中国知网、维普、Ovid、Pubmed数据库中检索与心理应激性心肌缺血(MSIMI)和传统压力相关性心肌缺血(CSIMI)有关的自身前后对照研究文献。按照纳入与排除标准提取资料并评价纳入研究的偏倚风险后,采用RevMan5.3软件进行Meta分析。结果最终纳入8篇文献,包括4371例患者,其中给予心理应激4371例,给予传统压力应激4364例。Meta分析结果显示,心理应激诱发稳定型冠心病患者急性心肌缺血的发生率低于传统压力应激[15.2%(664/4371)比32.4%(1414/4364)],差异有统计学意义(比值比=0.37,95%置信区间:0.34~0.41,P<0.05)。不同性别稳定型冠心病患者MSIMI和CSIMI发生率比较差异均无统计学意义(风险差=1.10,95%置信区间:0.79~1.53,P=0.57;风险差=0.00,95%置信区间:-0.10~0.11,P=0.98)。结论在稳定型冠心病患者中MSIMI的发生率较CSIMI低,但不同性别患者的MSIMI和CSIMI的发生率未见明显差异。
Objective To assess the incidence of myocardial ischemia induced by mental stress and conventional stress in patients with stable coronary atherosclerotic heart disease (CHD) and to analyze the difference between gender.Methods Self-controlled literatures related to mental stress-induced myocardial ischemia(MSIMI) and conventional stress-related myocardial ischemia (CSIMI) were identified using Wanfang Medical Network,China National Knowledge Infrastructure,VIP Database,Ovid and Pubmed.Valid data were retrieved in compliance with the inclusion and exclusion criteria.Risk of bias of the studies was evaluated.Meta-analysis was performed using RevMan 5.3 software.Results Eight literatures were included,including 4 371 patients,of whom 4 371 were treated with mental stress and 4 364 were treated with conventional stress.Meta-analysis showed that the incidence of MSIMI was lower than that of CSIMI [15.2% (664/4 371) vs 32.4% (1 414/4 364)],with significant difference (odds ratio =0.37,95% confidence interval:0.34-0.41,P < 0.05).No significant difference was observed in the incidences of MSIMI and CSMI between males and females (risk difference =1.10,95% confidence interval:0.79-1.53,P =0.57;risk difference =0.00,95% confidence interval:-0.10-0.11,P =0.98).Conclusions The incidence of MSIMI in patients with CHD is lower than that of CSIMI.There is no significant difference in the incidence of MSIMI and CSMI between genders.
作者
郗萌
周蓉
任延平
Xi Meng;Zhou Rong;Ren Yanping(The First Department of Geriatrics,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710062,China)
出处
《中国医药》
2019年第9期1289-1293,共5页
China Medicine
基金
陕西省自然科学基础研究计划(2016JM8072)~~
关键词
稳定型冠状动脉粥样硬化性心脏病
心理应激性心肌缺血
传统压力相关性心肌缺血
Stable coronary atherosclerotic heart disease
Mental stress-induced myocardial ischemia
Conventional stress-induced myocardial ischemia
