摘要
背景慢性心力衰竭(chronic heart failure,CHF)患者常合并认知功能障碍(cognitive impairment,CI),且CHF合并CI者预后不良发生率较高,及早识别影响CHF患者发生CI的因素具有重要意义。目前,虽然有研究者对CHF患者发生CI的影响因素进行了探讨,但不同研究的结果之间存在较大差异。目的系统评价CHF患者发生CI的影响因素。方法于2021年8月,计算机检索PubMed、EmBase、The Cochrane Library、Web of Science、CINAHL、PsychINFO、中国知网、万方数据知识服务平台、维普中文科技期刊全文数据库、中国生物医学文献数据库,获取有关CHF患者发生CI影响因素的研究,检索时限均为建库至2021年8月。由2名研究者独立筛选文献、提取资料并采用纽卡斯尔-渥太华(Newcastle-Ottawa Scale,NOS)量表、美国卫生保健质量和研究机构(Agency for Healthcare Research and Quality,AHRQ)推荐的横断面研究质量评价量表对文献的偏倚风险进行评价后,对影响CHF患者发生CI的因素进行描述性分析,并采用RevMan 5.3软件进行Meta分析。结果共纳入14项研究,调查样本量合计6324例,其中CHF合并CI者1753例。描述性分析结果显示:14项研究共发现5种保护因素,22种危险因素;性别和收缩压水平对CHF患者发生CI的影响尚无定论。Meta分析结果显示,受教育程度〔OR=0.45,95%CI(0.30,0.70)〕、年龄〔OR=1.17,95%CI(1.10,1.24)〕、糖尿病〔OR=2.17,95%CI(1.17,4.01)〕、贫血〔OR=3.03,95%CI(1.80,5.10)〕、左心室射血分数〔OR=0.91,95%CI(0.88,0.94)〕是CHF患者发生CI的影响因素。结论受教育程度高是CHF患者CI发生的保护因素,而年龄增长、糖尿病、贫血、左心室射血分数下降是CHF患者CI发生的危险因素。受纳入研究数量和质量的限制,上述结论需更多高质量研究予以验证。
Background Cognitive impairment(CI)is a common complication of chronic heart failure(CHF),which may significantly increase the risk of poor prognosis,so early identification of associated factors of CI in CHF is of great significance.Although there have been many relevant studies recently,their conclusions are inconsistent.Objective To perform a systematic review of the influencing factors of CI in CHF.Methods In August 2021,studies relevant to influencing factors of CI among patients with CHF were searched in databases including PubMed,Embase,The Cochrane Library,Web of Science,CINAHL,PsychINFO,CNKI,Wanfang Data,CQVIP,and SinoMed from inception to August 2021.Two researchers independently screened studies based on the inclusion and exclusion criteria,extracted data,and performed risk of bias assessment using the Newcastle-Ottawa Scale and The Agency for Healthcare Research and Quality methodology checklist,then conducted a descriptive analysis of the factors associated with CI in CHF.RevMan 5.3 was adopted for meta-analysis.Results Fourteen studies were included,involving 6324 cases of CHF,and 1753 of them also with CI.Descriptive analysis indicated that five factors decreased the risk of CI in CHF,and 22 factors increased the risk,but the influence of sex and systolic blood pressure on CI is still far from inclusive.Meta-analysis demonstrated that education level〔OR=0.45,95%CI(0.30,0.70)〕,age〔OR=1.17,95%CI(1.10,1.24)〕,diabetes〔OR=2.17,95%CI(1.17,4.01)〕,anemia〔OR=3.03,95%CI(1.80,5.10)〕and left ventricular ejection fraction〔OR=0.91,95%CI(0.88,0.94)〕were associated with CI in CHF.Conclusion High education level lowered the risk of CI in CHF,while older age,diabetes,anemia and decreased left ventricular ejection fraction increased the risk.Due to limited number and quality of included studies,the above-mentioned conclusion still needs to be verified by more high-quality studies.
作者
杨慧锋
牛伟华
施月仙
张丽娟
杨婷
YANG Huifeng;NIU Weihua;SHI Yuexian;ZHANG Lijuan;YANG Ting(School of Nursing,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Department of Cardiology,Tianjin First Central Hospital,Tianjin 300192,China;School of Nursing,Peking University Health Science Center,Beijing 100871,China;School of Nursing,Liaoning University of Traditional Chinese Medicine,Liaoning 100847,China)
出处
《中国全科医学》
CAS
北大核心
2022年第13期1642-1650,共9页
Chinese General Practice
基金
国家自然科学基金资助项目(72004161)。
关键词
慢性心力衰竭
认知功能障碍
影响因素
系统评价
Chronic heart failure
Cognitive impairment
Influencing factors
Systematic review
