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肾结石患者患冠心病的风险:一项系统评价和荟萃分析。

The Risk of Coronary Heart Disease in Patients with Kidney Stones: A Systematic Review and Meta-analysis.

作者信息

Cheungpasitporn Wisit, Thongprayoon Charat, Mao Michael A, O'Corragain Oisin A, Edmonds Peter J, Erickson Stephen B

机构信息

Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.

University College Cork, Cork, Ireland.

出版信息

N Am J Med Sci. 2014 Nov;6(11):580-5. doi: 10.4103/1947-2714.145477.

Abstract

BACKGROUND

The reported risk of coronary heart disease (CHD) in patients with a history of kidney stones is conflicting.

AIMS

The objective of this meta-analysis was to assess the association between a history of kidney stones and CHD risk.

MATERIALS AND METHODS

A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception until April 04, 2014. Studies that reported odds ratios or hazard ratios comparing the risk of CHD in patients with a history of kidney stones versus those without a history of kidney stones were included. Pooled risk ratios (RRs) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method.

RESULTS

Seven study populations from four cohort studies and one cross-sectional study were identified and included in the data analysis. The pooled risk ratio (RR) of CHD in patients with kidney stones was 1.24 (95% CI, 1.10-1.40). This result remained significant (RR, 1.23 [95% CI, 1.08-1.41]) when the sensitivity analysis was restricted to only cohort studies. A history of kidney stones was associated with increased CHD risk in females (RR, 1.43 [95% CI, 1.12-1.82]), whereas the association was not significant in males (RR, 1.14 [95% CI, 0.94-1.38]).

CONCLUSIONS

Our study demonstrates a statistically significant increased risk of CHD in female patients with prior kidney stones. This finding suggests that a history of kidney stones is a risk factor for CHD in females and may impact clinical management.

摘要

背景

有肾结石病史的患者患冠心病(CHD)的风险报道存在矛盾。

目的

本荟萃分析的目的是评估肾结石病史与冠心病风险之间的关联。

材料与方法

使用MEDLINE、EMBASE和Cochrane系统评价数据库进行文献检索,检索时间从建库至2014年4月4日。纳入报告了比较有肾结石病史患者与无肾结石病史患者冠心病风险的比值比或风险比的研究。采用随机效应、通用逆方差法计算合并风险比(RRs)和95%置信区间(CI)。

结果

确定了来自四项队列研究和一项横断面研究的七个研究人群并纳入数据分析。有肾结石患者患冠心病的合并风险比(RR)为1.24(95%CI,1.10 - 1.40)。当敏感性分析仅限于队列研究时,该结果仍然显著(RR,1.23 [95%CI,1.08 - 1.41])。肾结石病史与女性冠心病风险增加相关(RR,1.43 [95%CI,1.12 - 1.82]),而在男性中这种关联不显著(RR,1.14 [95%CI,0.94 - 1.38])。

结论

我们的研究表明,既往有肾结石的女性患者患冠心病的风险在统计学上显著增加。这一发现表明,肾结石病史是女性冠心病的一个危险因素,可能会影响临床管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b28/4264294/6146e865933a/NAJMS-6-580-g002.jpg

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