Zhang Jing, Song Yanlin, Shan Baoyin, He Min, Ren Qingqing, Zeng Yunhui, Liu Zhiyong, Liu Hao, Xu Jianguo
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 610041, PR China.
West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041, PR China.
Oncotarget. 2017 Dec 18;9(2):2208-2219. doi: 10.18632/oncotarget.23367. eCollection 2018 Jan 5.
The aim of this study was to systematically evaluate the association between D-dimer level and the risk of stroke through performing a meta-analysis. PubMed, Web of Science, EMBASE and Cochrane Library were searched for potentially eligible literature. Prospective observational studies or case-control studies were included. The study characteristics and relevant data were extracted. Hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were pooled to estimate the association between D-dimer level and the risk of stroke. Seven prospective studies with 22,207 patients and three case-control studies with 2,248 patients were included. For the prospective studies, the pooled HRs of higher D-dimer level for all types of stroke, ischemic stroke and hemorrhagic stroke were 1.55 (95% CI, 1.28- 1.87), 1.62 (95% CI, 1.18-2.22) and 1.30 (95% CI, 0.63-2.68), respectively. The pooled HRs per SD increase in log D-dimer for all types of stroke, ischemic stroke and hemorrhagic stroke were 1.16 (95% CI, 1.06-1.26), 1.11 (95% CI, 1.03-1.21) and 1.11 (95% CI, 0.95-1.30), respectively. For the case-control studies, the pooled OR of higher D-dimer level for acute ischemic stroke was 2.06 (95% CI, 1.08-3.96). No significant publication bias was found in the meta-analysis. In conclusion, our results suggested that higher D-dimer level was associated with higher risk of stroke, especially ischemic stroke.
本研究的目的是通过进行一项荟萃分析，系统地评估D - 二聚体水平与中风风险之间的关联。检索了PubMed、科学网、EMBASE和Cochrane图书馆，以查找可能符合条件的文献。纳入前瞻性观察性研究或病例对照研究。提取了研究特征和相关数据。汇总具有95%置信区间（CI）的风险比（HRs）或比值比（ORs），以估计D - 二聚体水平与中风风险之间的关联。纳入了7项有22207名患者的前瞻性研究和3项有2248名患者的病例对照研究。对于前瞻性研究，所有类型中风、缺血性中风和出血性中风的D - 二聚体水平较高的汇总HRs分别为1.55（95%CI，1.28 - 1.87）、1.62（95%CI，1.18 - 2.22）和1.30（95%CI，0.63 - 2.68）。所有类型中风、缺血性中风和出血性中风的log D - 二聚体每增加一个标准差的汇总HRs分别为1.16（95%CI，1.06 - 1.26）、1.11（95%CI，1.03 - 1.21）和1.11（95%CI，0.95 - 1.30）。对于病例对照研究，急性缺血性中风的D - 二聚体水平较高的汇总OR为2.06（95%CI，1.08 - 3.96）。荟萃分析中未发现明显的发表偏倚。总之，我们的结果表明，较高的D - 二聚体水平与较高的中风风险相关，尤其是缺血性中风。
