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脑性瘫痪成人的心血管疾病及相关危险因素:系统评价。

Cardiovascular disease and related risk factors in adults with cerebral palsy: a systematic review.

机构信息

School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.

CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.

出版信息

Dev Med Child Neurol. 2019 Aug;61(8):915-923. doi: 10.1111/dmcn.14028. Epub 2018 Sep 17.

Abstract

AIM

To summarize the literature on the prevalence of cardiovascular disease (CVD), risk factors of CVD, and CVD-related mortality in adults with cerebral palsy (CP).

METHOD

A systematic review was conducted by searching the PubMed, Embase, MEDLINE (Ovid), Cochrane, and CINAHL databases. Selection criteria included adults with CP aged 18 years or over. Methodological quality was assessed using the Newcastle-Ottawa scale for observational studies. Data were reported descriptively.

RESULTS

Nineteen studies met the inclusion criteria. Only one study reported directly on the presence of CVD in adults with CP, which found adults with CP reported greater CVD conditions than adults without CP (15.1 vs 9.1%, p<0.001). The most commonly reported risk factor of CVD in adults with CP was overweight/obesity. Five studies included data on CVD-related mortality in persons with CP, where CVD-related and circulatory system-related deaths were elevated and more common at a younger age in adults with CP than in the general population.

INTERPRETATION

The prevalence of CVD and the risk of death because of CVD in this population seems increased, though the knowledge base is fragmented by studies that are small in size and geographically isolated. Further research is required to understand prevalence of risk factors among adults with CP, in particular overweight/obesity.

WHAT THIS PAPER ADDS

Overweight and obesity are risk factors of cardiovascular disease (CVD) that are commonly reported in adults with cerebral palsy (CP). CVD-related and circulatory system-related deaths are elevated in individuals with CP compared to the general population.

摘要

目的

总结成年人脑瘫(CP)患者心血管疾病(CVD)的患病率、CVD 风险因素以及与 CVD 相关的死亡率的文献。

方法

通过检索 PubMed、Embase、MEDLINE(Ovid)、Cochrane 和 CINAHL 数据库进行系统评价。纳入标准为年龄≥18 岁的 CP 成年人。使用纽卡斯尔-渥太华量表评估观察性研究的方法学质量。数据以描述性报告。

结果

19 项研究符合纳入标准。仅有一项研究直接报告了 CP 成年人中 CVD 的存在情况,发现 CP 成年人报告的 CVD 情况比非 CP 成年人更为严重(15.1%比 9.1%,p<0.001)。CP 成年人中最常报告的 CVD 风险因素是超重/肥胖。五项研究包含了 CP 患者 CVD 相关死亡率的数据,CP 成年人的 CVD 相关和循环系统相关死亡在年轻时升高且更为常见。

结论

尽管由于研究规模小且地理位置孤立,知识基础支离破碎,但该人群中 CVD 的患病率和 CVD 死亡风险似乎增加。需要进一步研究以了解 CP 成年人中危险因素的流行情况,特别是超重/肥胖。

本文的新增内容

超重和肥胖是 CP 成年人 CVD 的常见风险因素。与普通人群相比,CP 个体的 CVD 相关和循环系统相关死亡更高。

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