OSAHS與高血壓相關(guān)性的系統(tǒng)評價
發(fā)布時間：2018-12-28 21:24
【摘要】：目的：運(yùn)用循證醫(yī)學(xué)系統(tǒng)評價的方法評估阻塞性睡眠呼吸暫停低通氣綜合征（OSAHS）與高血壓之間的相關(guān)性。 方法：采用Cochrane系統(tǒng)評價的研究方法，確定研究課題，制定合適的納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn)。按照納入及排除標(biāo)準(zhǔn)制定合理的檢索策略檢索相關(guān)文獻(xiàn)。計算機(jī)檢索COCHRANE圖書館、MEDLINE（1950~2011.4）EMBASE(1989~2011.4)、維普VIP(1989~2011.4)、萬方（1977~2011.4）、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫CBM（1978~2011.4）、相關(guān)期刊論文CNKI（1979~2011.4），查找公開發(fā)表的OSAHS與高血壓相關(guān)性的文獻(xiàn)。查找相關(guān)會議文獻(xiàn)及未公開發(fā)表的相關(guān)文章，咨詢本領(lǐng)域?qū)＜乙垣@得相關(guān)資料。根據(jù)納入排除標(biāo)準(zhǔn)對檢出文獻(xiàn)進(jìn)行篩選，納入OSAHS與高血壓相關(guān)性的隊列研究和病例對照研究。整理納入文獻(xiàn)，對納入文獻(xiàn)質(zhì)量進(jìn)行評估，提取相關(guān)數(shù)據(jù)。收集資料、評估納入研究質(zhì)量工作由兩名研究員獨立完成。運(yùn)用RevMan5.1.2軟件分析納入文獻(xiàn)，評估文獻(xiàn)的異質(zhì)性，按照研究類型及OSAHS病情分級分別進(jìn)行META分析，評估OSAHS與高血壓直接的相關(guān)性及相關(guān)性是否與OSAHS病情分級有關(guān)。評估納入文獻(xiàn)的發(fā)表偏移。運(yùn)用GRADE3.6軟件評估證據(jù)質(zhì)量。 結(jié)果：共檢出相關(guān)文獻(xiàn)2224篇，初篩選出89篇，復(fù)篩排除79篇，最終共納入文獻(xiàn)11篇，觀察對象總計4019名。其中，前瞻性隊列研究1篇，觀察病例346人；病例對照研究10篇，觀察病例3673人。按照異質(zhì)性分析結(jié)果，將納入文獻(xiàn)分成不同的亞組進(jìn)行分析并繪制森林圖。Meta分析結(jié)果顯示：①按照研究類型將納入文獻(xiàn)分為病例對照組及隊列研究組。META分析結(jié)果顯示P=0.16，，RR=2.52，95%CI（2.21,2.87），說明病例組與對照組之間的差異有統(tǒng)計學(xué)意義，提示OSAHS與高血壓之間存在相關(guān)性;②按照OSAHS病情分級，將納入文獻(xiàn)分為輕度、中度及重度3個亞組。META分析結(jié)果顯示P=0. 83，RR=1.84，95%CI（1.53,2.22），說明病例組與對照組之間的差異有統(tǒng)計學(xué)意義，提示OSAHS與高血壓的相關(guān)性與OSAHS病情分級有關(guān)。且OSAHS分級越重，患者患高血壓可能性越大。發(fā)表偏倚分析結(jié)果顯示“漏斗圖”圖形不對稱，提示可能存在發(fā)表偏倚。運(yùn)用GRADE軟件分析納入文獻(xiàn)質(zhì)量等級，結(jié)果為“very low”。 結(jié)論：現(xiàn)有證據(jù)表明，OSAHS與高血壓呈顯著相關(guān)，可能互為危險因素。且OSAHS與高血壓相關(guān)性可能與OSAHS病情分級有關(guān)，OSAHS病情越重，并發(fā)高血壓的可能性就越大。本研究納入文獻(xiàn)質(zhì)量等級較低，目前缺乏大量的、高質(zhì)量的針對OSAHS與高血壓相關(guān)性的研究，特別是前瞻性隊列研究。
[Abstract]:Objective: to evaluate the correlation between obstructive sleep apnea hypopnea syndrome (OSAHS) and hypertension by the method of evidence-based medicine system evaluation. Methods: Cochrane system evaluation method was used to determine the research topics and to formulate appropriate inclusion criteria and exclusion criteria. According to the inclusion and exclusion criteria to formulate a reasonable retrieval strategy to retrieve relevant literature. Computer search for COCHRANE Library (, MEDLINE (1950 / 2011.4) EMBASE (1989 / 2011.4), Weip VIP (1989 / 2011.4), Wanfang (1977 / 2011.4), Chinese Biomedical Literature Database CBM (1978 / 2011.4), China Journal Full-text Database (CNKI (1979 / 2011.4), Chinese Journal Database (1979 / 2011.4), China Biomedical Literature Database CBM (1978 / 2011.4) Find published literature on the association of OSAHS with hypertension. Find relevant conference documents and unpublished articles, consult experts in this field to obtain relevant information. The literature was screened according to the inclusion exclusion criteria, and the cohort study and case-control study on the correlation between OSAHS and hypertension were carried out. Collate the literature, evaluate the quality of the literature, and extract the relevant data. Collecting data and evaluating the quality of the research were done independently by two researchers. The RevMan5.1.2 software was used to analyze the literature to evaluate the heterogeneity of the literature. According to the type of study and the grade of OSAHS, the META analysis was carried out to assess the direct correlation between OSAHS and hypertension and whether the correlation was related to the grade of OSAHS. The evaluation includes publication offsets of the literature. Use GRADE3.6 software to evaluate the quality of evidence. Results: a total of 2224 articles were identified, 89 articles were screened out, 79 articles were excluded, and 11 papers were included. A total of 4019 subjects were observed. There were 1 prospective cohort study with 346 cases observed and 10 case-control studies with 3673 cases observed. According to the results of heterogeneity analysis, The results of Meta analysis showed that: (1) according to the type of study, the included literature was divided into case control group and cohort study group. RR=2.52,95%CI (2.21 鹵2.87), indicating that the difference between the case group and the control group is statistically significant, suggesting that there is a correlation between OSAHS and hypertension. 2 according to the grade of OSAHS, the included literature was divided into three subgroups: mild, moderate and severe. META analysis showed that P0. The CI (1.83 鹵2.22) indicated that the difference between the case group and the control group was statistically significant, suggesting that the correlation between OSAHS and hypertension was related to the grade of OSAHS. And the more severe the OSAHS grade, the more likely patients are to develop hypertension. The results of publication bias analysis showed that the funnel graph was asymmetrical, suggesting that there might be publication bias. GRADE software was used to analyze the literature quality and the result was "very low". Conclusion: available evidence suggests that OSAHS is significantly associated with hypertension and may be a risk factor. The correlation between OSAHS and hypertension may be related to the grade of OSAHS. The more serious the OSAHS, the more likely it is to develop hypertension. This study included a low quality literature, and a large number of high-quality studies on the association between OSAHS and hypertension, especially prospective cohort studies, were lacking.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R766;R544.1
本文編號：2394455
[Abstract]:Objective: to evaluate the correlation between obstructive sleep apnea hypopnea syndrome (OSAHS) and hypertension by the method of evidence-based medicine system evaluation. Methods: Cochrane system evaluation method was used to determine the research topics and to formulate appropriate inclusion criteria and exclusion criteria. According to the inclusion and exclusion criteria to formulate a reasonable retrieval strategy to retrieve relevant literature. Computer search for COCHRANE Library (, MEDLINE (1950 / 2011.4) EMBASE (1989 / 2011.4), Weip VIP (1989 / 2011.4), Wanfang (1977 / 2011.4), Chinese Biomedical Literature Database CBM (1978 / 2011.4), China Journal Full-text Database (CNKI (1979 / 2011.4), Chinese Journal Database (1979 / 2011.4), China Biomedical Literature Database CBM (1978 / 2011.4) Find published literature on the association of OSAHS with hypertension. Find relevant conference documents and unpublished articles, consult experts in this field to obtain relevant information. The literature was screened according to the inclusion exclusion criteria, and the cohort study and case-control study on the correlation between OSAHS and hypertension were carried out. Collate the literature, evaluate the quality of the literature, and extract the relevant data. Collecting data and evaluating the quality of the research were done independently by two researchers. The RevMan5.1.2 software was used to analyze the literature to evaluate the heterogeneity of the literature. According to the type of study and the grade of OSAHS, the META analysis was carried out to assess the direct correlation between OSAHS and hypertension and whether the correlation was related to the grade of OSAHS. The evaluation includes publication offsets of the literature. Use GRADE3.6 software to evaluate the quality of evidence. Results: a total of 2224 articles were identified, 89 articles were screened out, 79 articles were excluded, and 11 papers were included. A total of 4019 subjects were observed. There were 1 prospective cohort study with 346 cases observed and 10 case-control studies with 3673 cases observed. According to the results of heterogeneity analysis, The results of Meta analysis showed that: (1) according to the type of study, the included literature was divided into case control group and cohort study group. RR=2.52,95%CI (2.21 鹵2.87), indicating that the difference between the case group and the control group is statistically significant, suggesting that there is a correlation between OSAHS and hypertension. 2 according to the grade of OSAHS, the included literature was divided into three subgroups: mild, moderate and severe. META analysis showed that P0. The CI (1.83 鹵2.22) indicated that the difference between the case group and the control group was statistically significant, suggesting that the correlation between OSAHS and hypertension was related to the grade of OSAHS. And the more severe the OSAHS grade, the more likely patients are to develop hypertension. The results of publication bias analysis showed that the funnel graph was asymmetrical, suggesting that there might be publication bias. GRADE software was used to analyze the literature quality and the result was "very low". Conclusion: available evidence suggests that OSAHS is significantly associated with hypertension and may be a risk factor. The correlation between OSAHS and hypertension may be related to the grade of OSAHS. The more serious the OSAHS, the more likely it is to develop hypertension. This study included a low quality literature, and a large number of high-quality studies on the association between OSAHS and hypertension, especially prospective cohort studies, were lacking.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R766;R544.1
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本文編號：2394455
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