脑卒中患者营养风险及危险因素的Meta分析

Nutritional Risk and Risk Factors in Stroke Patients: A Meta-Analysis

摘要: 目的：运用系统评价方式探讨脑卒中患者的营养风险及危险因素，为更好地预防卒中后营养不良提供循证依据。方法：计算机全面系统地检索中国知网(CNKI)、万方数据库(Wanfang)、维普中文科技期刊数据库(VIP)、PubMed、The Cochrane Library等数据库。文献筛选依据纳入与排除标准，并采用Newcastle-Ottawa Scale (NOS)量表对所纳入的文献进行质量评价。收集到有效数据后，应用RevMan 5.4软件对相关数据进行Meta分析，并对主要结局指标进行敏感性分析。结果：共计纳入9篇符合标准的文献，总样本量为2302例，Meta分析的结果显示，卒中后营养风险的危险因素有：神经功能缺损程度(NIHSS ≥ 5分)、年龄(≥60岁)、吞咽障碍、心脏病史、吸烟、饮酒(P值均小于0.05)。而营养干预可以降低脑卒中患者营养风险的发生(P值小于0.05)。与卒中史、高血压史、糖尿病史无关(P值均大于0.05)。结论：神经功能缺损程度(NIHSS ≥ 5分)、年龄(≥60岁)、吞咽障碍、心脏病史、吸烟、饮酒是脑卒中患者营养风险的危险因素。营养干预有利于降低营养风险的发生。

Abstract: Objective: The exploration of nutritional risks and risk factors in stroke patients using systematic evaluation methods provides evidence-based support for better prevention of post-stroke malnutrition. Methods: We systemically searched relevant studies in CNKI, Wanfang, VIP, PubMed and The Cochrane Library. The literatures were screened according to inclusion and exclusion criteria, and the quality of the included literatures were evaluated by the Newcastle-Ottawa Scale (NOS) scale. After then, using RevMan 5.4 software for meta-analysis, and sensitivity analysis for the primary outcome measures. Results: Nine studies with 2302 participants were involved. The analysis showed that the risk factors for nutritional risk in stroke patients included degree of neurological impairment (NIHSS ≥ 5 points), age (≥60 years), dysphagia, cardiac history, smoking and drinking (P < 0.05). Nutritional intervention could reduce the incidence of nutritional risk in stroke patients (P < 0.05). Conversely, history of stroke, hypertension and diabetes were most likely not associated with post-stroke nutritional risk (P > 0.05). Conclusions: Degree of neurological impairment (NIHSS ≥ 5 points), age (≥60 years), dysphagia, cardiac history, smoking and drinking are risk factors for nutritional risk in stroke patients. Nutritional intervention is beneficial to reduce the happened of nutritional risk.