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甲状腺功能亢进症患者静脉血栓栓塞风险增加:队列研究的系统评价和荟萃分析。

Increased risk of venous thromboembolism among patients with hyperthyroidism: a systematic review and meta-analysis of cohort studies.

机构信息

Pranangklao Hospital, Bangkok, Thailand.

Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Eur J Intern Med. 2019 Sep;67:65-69. doi: 10.1016/j.ejim.2019.06.012. Epub 2019 Jun 19.

Abstract

BACKGROUND

Studies have suggested that patients with hyperthyroidism may have a higher risk of venous thromboembolism (VTE) compared to individuals with normal thyroid function, although the data is quite limited. This systematic review and meta-analysis aims to comprehensively investigate this risk by summarizing all available studies.

METHODS

A systematic review was performed using the MEDLINE and Embase databases from inception to February 2019 to identify all cohort studies that compared the risk of incident VTE in patients with hyperthyroidism versus individuals without hyperthyroidism. Pooled risk ratio and 95% confidence interval were calculated using random-effect, generic inverse-variance method.

RESULTS

A total of 5 retrospective cohort studies with 237,667 cases with hyperthyroidism and 4,615,907 comparators without hyperthyroidism were included. The pooled analysis found a significantly increased risk of incident VTE among patients with hyperthyroidism, with a pooled risk ratio of 1.332 (95% CI, 1.275-1.391; I 14%). The funnel plot was asymmetric and may suggest the presence of publication bias in favor of studies that showed positive association.

CONCLUSION

A significantly increased risk of incident VTE among patients with hyperthyroidism compared to individuals without hyperthyroidism was demonstrated in this meta-analysis.

摘要

背景

研究表明,与甲状腺功能正常的个体相比,甲状腺功能亢进症患者发生静脉血栓栓塞症(VTE)的风险可能更高,尽管数据相当有限。本系统评价和荟萃分析旨在通过总结所有可用的研究来全面评估这种风险。

方法

使用 MEDLINE 和 Embase 数据库,从创建到 2019 年 2 月进行系统评价,以确定所有比较甲状腺功能亢进症患者与无甲状腺功能亢进症个体发生 VTE 风险的队列研究。使用随机效应、通用倒数方差法计算汇总风险比和 95%置信区间。

结果

共纳入 5 项回顾性队列研究,其中 237667 例甲状腺功能亢进症患者和 4615907 例无甲状腺功能亢进症对照者。汇总分析发现,甲状腺功能亢进症患者发生 VTE 的风险显著增加,汇总风险比为 1.332(95%可信区间,1.275-1.391;I 14%)。漏斗图不对称,可能表明存在发表偏倚,偏向于显示阳性关联的研究。

结论

与无甲状腺功能亢进症个体相比,甲状腺功能亢进症患者发生 VTE 的风险显著增加。

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