癫痫共患抑郁影响因素的Meta分析

Meta-Analysis of Influencing Factors of Depression Associated with Epilepsy

摘要: 目的：探讨癫痫患者共患抑郁的影响因素，对其开展有针对性的早期临床识别和干预提供参考。方法：以癫痫、癫痫症、抑郁、精神疾病、影响因素、危险因素、相关因素等为关键词或主题词检索中国知网(CNKI)、万方数据库(WanFang)、中国生物医学文献数据库(CBM)、维普数据库(VIP)、PubMed、Embase、the Cochrane Library等数据库，全面搜集关于癫痫共患抑郁影响因素的相关文献，检索时限为建库起至2022年。筛选后提取文献中的作者姓名、年份、影响因素、研究类型、经多变量分析的OR值及95% CI等资料，利用STATA17.0软件展开Meta统计学分析。结果：(1) 18篇文献纳入“发作频率”的研究，进行亚组分析后，发作频率 ≥ 1次/月、发作频率 > 2次/月均有统计学意义(P < 0.05)。(2) 7篇文献纳入“抗癫痫药物的种类”的研究，进行亚组分析，发现应用汉密尔顿抑郁量表(Hamilton Depression Scale, HAMD)筛查抑郁的亚组分析具有统计学意义(P < 0.05)，应用抑郁自评量表(Self-rating depression Scale, SDS)、贝克抑郁量表(Back Depression Inventory, BDI-II)筛查抑郁的亚组分析无统计学意义(P > 0.05)。(3) 10篇文献纳入“病程”的研究，进行亚组分析，发现应用HAMD量表、SDS量表筛查抑郁的亚组分析有统计学意义(P < 0.05)；应用BDI抑郁量表筛查抑郁的亚组分析无统计学意义(P > 0.05)。结论：发作频率、抗癫痫药物的种类、病程是癫痫共患抑郁的影响因素。

Abstract: Objective: To explore the influencing factors of comorbidity depression in epilepsy patients, and to provide reference for early clinical identification and intervention. Method: Epilepsy, seizure disorder, depression, mental illness, influencing factors, risk factors, related factors, etc., were used as keywords or subject terms to search China National Knowledge Network (CNKI), WanFang Database, China Biomedical Literature Database (CBM), VIP database, PubMed, Embase, the Cochrane Library and other databases comprehensively collected relevant literature on the factors affecting depression with epilepsy, and the search period was from the establishment of the database to 2022. After screening, authors’ names, years, influencing factors, study types, multivariate analysis of OR and 95% CI were extracted, and meta-statistical analysis was performed using STATA17.0 software. Results: (1) Eighteen articles were included in the study of “attack frequency”, and after subgroup analysis, the frequency of attacks ≥ 1 times/month and frequency >2 times/month were statistically significant (P < 0.05). (2) Seven literatures were included in the “types of anti-epileptic drugs” study, and subgroup analysis was conducted. It was found that the subgroup analysis of the application of Hamilton depression scale (HAMD) to screen for depression had statistical significance (P < 0.05). The subgroup analysis of Self-rating depression Scale (SDS) and Back Depression Inventory (BDI-II) showed no statistical significance (P > 0.05). (3) 10 literatures were included in the study of “disease course”, and subgroup analysis was conducted, and it was found that the subgroup analysis of screening depression by HAMD scale and SDS scale had statistical significance (P < 0.05); There was no statistical significance in subgroup analysis of depression screening with BDI depression scale (P > 0.05). Conclusion: The frequency of seizure, the type of antiepileptic drugs and the course of the disease are the influencing factors of epilepsy co-induced depression.