Dong Xiao-Liu, Guan Fei, Xu Shi-Jun, Zhu Li-Xia, Zhang Pan-Pan, Cheng Ai-Bin, Liu Tie-Jun
Department of Neurology, Tangshan People's Hospital, Tangshan 063000, P.R. China.
Department of Emergency, Tangshan People's Hospital, Tangshan 063000, P.R. China.
J Res Med Sci. 2018 Jan 29;23:10. doi: 10.4103/1735-1995.223951. eCollection 2018.
We carried out this meta-analysis for the aim of exploring the influence of diabetes mellitus (DM) on the prognosis of patients with ischemic stroke. Relevant studies were identified using computerized databases supplemented with manual search strategies. The included studies were strictly followed the inclusion and exclusion criteria. Case-control studies which related to the influence of DM on the prognosis of patients with ischemic stroke were selected. Statistical analyses were implemented with the STATA version 12.0 statistical software. Our current meta-analysis initially retrieved 253 studies (227 in Chinese and 26 in English), 13 studies (6 in English and 7 in Chinese) were eventually incorporated in this meta-analysis. These 13 case-control studies included 8463 patients altogether (3249 patients with DM complicated with ischemic stroke and 5214 patients with ischemic stroke). The results of this meta-analysis manifested that there was a significant difference of the blood glucose level at 48 h after stroke between patients with DM complicated with ischemic stroke and patients with ischemic stroke (standard mean difference [SMD] =1.27, 95% confidence interval [CI] =0.02-2.51, = 0.047); however, the effectiveness, fatality, and the National Institutes of Health Stroke Scale (NIHSS) score in patients with DM complicated with ischemic stroke, and patients with ischemic stroke had no significant difference (effectiveness: risk ratio [RR] = 0.88, 95% CI = 0.75-1.03, = 0.121; fatality: RR = 1.29, 95% CI = 0.97-1.71, = 0.081; NIHSS score: SMD = -0.14, 95% CI = -1.56-1.28, = 0.849). The current evidence suggests that there is statistical difference of the blood glucose level at 48 h after stroke between patients with DM complicated with ischemic stroke and patients with ischemic stroke, but there is no statistical difference of prognostic indicators between patients in two groups. Thus, our study provides certain clinical value.
我们进行这项荟萃分析的目的是探讨糖尿病（DM）对缺血性脑卒中患者预后的影响。通过计算机数据库并辅以手动检索策略来识别相关研究。纳入的研究严格遵循纳入和排除标准。选择了与DM对缺血性脑卒中患者预后影响相关的病例对照研究。使用STATA 12.0版统计软件进行统计分析。我们当前的荟萃分析最初检索到253项研究（227项中文研究和26项英文研究），最终有13项研究（6项英文研究和7项中文研究）纳入了该荟萃分析。这13项病例对照研究共纳入8463例患者（3249例DM合并缺血性脑卒中患者和5214例缺血性脑卒中患者）。该荟萃分析结果表明，DM合并缺血性脑卒中患者与缺血性脑卒中患者在卒中后48小时的血糖水平存在显著差异（标准均差[SMD]=1.27，95%置信区间[CI]=0.02 - 2.51，P = 0.047）；然而，DM合并缺血性脑卒中患者与缺血性脑卒中患者在有效性、死亡率和美国国立卫生研究院卒中量表（NIHSS）评分方面无显著差异（有效性：风险比[RR]=0.88，95% CI = 0.75 - 1.03，P = 0.121；死亡率：RR = 1.29，95% CI = 0.97 - 1.71，P = 0.081；NIHSS评分：SMD = -0.14，95% CI = - \alpha - 1.28，P = 0.849）。目前的证据表明，DM合并缺血性脑卒中患者与缺血性脑卒中患者在卒中后48小时的血糖水平存在统计学差异，但两组患者的预后指标无统计学差异。因此，我们的研究具有一定的临床价值。
（注：原文中“95% CI = - \alpha - 1.28”这里的“\alpha”可能有误，未明确其准确含义，翻译时保留原文形式。）
