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使用扩散张量成像预测缺血性中风后的运动恢复:一项荟萃分析。

Prediction of motor recovery after ischemic stroke using diffusion tensor imaging: A meta-analysis.

作者信息

Jin Jing-Fen, Guo Zhi-Ting, Zhang Yu-Ping, Chen Yuan-Yuan

机构信息

Nursing Department, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China.

Neurology Department, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China.

出版信息

World J Emerg Med. 2017;8(2):99-105. doi: 10.5847/wjem.j.1920-8642.2017.02.003.

Abstract

BACKGROUND

This systematic review aims to investigate the prediction value of diffusion tensor imaging for motor function recovery of ischemic stroke patients.

METHODS

Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 9), PubMed, Embase, Clarivate Analytics, Scopus, CINAHL, Chinese Biomedical Literature Database, China National Knowledge Infrastructure and Google Scholar were searched for either motor recovery or corticospinal tract integrity by diffusion tensor imaging in different stroke phase from January 1, 1970, to October 31, 2016. The study design and participants were subjected to metrological analysis. Correlation coefficient (r) was used for evaluating the relationship between fractional anisotropy (FA) and motor function outcome. Correlation coefficient values were extracted from each study, and 95% confidence intervals (CIs) were calculated by Fisher's z transformation. Meta-analysis was conducted by STATA software.

RESULTS

Fifteen studies with a total of 414 patients were included. Meta-analysis showed that FA in the subacute phase had the significant correlation with motor function outcome (ES=0.75, 95% 0.62-0.87), which showed moderate quality based on GRADE system. The weight correlation coefficient revealed that an effect size (ES) of FA in acute phase and chronic phase was 0.51 (95% 0.33-0.68) and 0.62 (95% 0.47-0.77) respectively.

CONCLUSION

This meta-analysis reveals that FA in the subacute phase after ischemic stroke is a good predictor for functional motor recovery, which shows moderate quality based on the GRADE system.

摘要

背景

本系统评价旨在探讨弥散张量成像对缺血性脑卒中患者运动功能恢复的预测价值。

方法

检索Cochrane对照试验中心注册库(CENTRAL)(Cochrane图书馆2016年第9期)、PubMed、Embase、科睿唯安分析数据库、Scopus、护理学与健康领域数据库、中国生物医学文献数据库、中国知网和谷歌学术,检索1970年1月1日至2016年10月31日期间不同卒中阶段通过弥散张量成像评估运动恢复或皮质脊髓束完整性的研究。对研究设计和参与者进行计量分析。采用相关系数(r)评估各向异性分数(FA)与运动功能结局之间的关系。从每项研究中提取相关系数值,并通过Fisher z变换计算95%置信区间(CI)。采用STATA软件进行Meta分析。

结果

纳入15项研究,共414例患者。Meta分析显示,亚急性期FA与运动功能结局显著相关(效应量=0.75,95%CI 0.62-0.87),根据GRADE系统,证据质量为中等。加权相关系数显示,急性期和慢性期FA的效应量分别为0.51(95%CI 0.33-0.68)和0.62(95%CI 0.47-0.77)。

结论

本Meta分析表明,缺血性脑卒中后亚急性期的FA是运动功能恢复的良好预测指标,根据GRADE系统,证据质量为中等。

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