无症状性脑梗死与认知功能之间的关联：一项系统评价与荟萃分析。
Association Between Silent Brain Infarcts and Cognitive Function: A Systematic Review and Meta-Analysis.
作者信息
Lei Chunyan, Deng Qionghua, Li Haijiang, Zhong Lianmei
机构信息
Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, PR China.
Department of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, PR China.
出版信息
J Stroke Cerebrovasc Dis. 2019 Sep;28(9):2376-2387. doi: 10.1016/j.jstrokecerebrovasdis.2019.03.036. Epub 2019 Jul 5.
BACKGROUND AND PURPOSE
Silent brain infarct (SBI), which has traditionally been considered clinically silent, has been proposed as a subclinical risk marker for future cognitive function decline.
METHODS
We conducted a systematic review of literature in the Cochrane Library, MEDLINE, EMBASE, and the China National Knowledge Infrastructure database.
RESULTS
In the end, 19 case-control studies, comprising 6712 participants, and 3 prospective cohort studies comprising 4433 participants, met all inclusion criteria and were included in the systematic review. Meta-analysis of 9 studies showed that SBI was an important factor in cognitive function decline (Mini-Mental State score) (standardized mean difference -.47, 95% confidence interval; -.72 to -.22). Another meta-analysis of 4 studies reported the SBI was an independent factor in cognitive dysfunction (Montreal Cognitive Assessment Scale) (standardized mean difference -3.36, 95% confidence interval; -5.90 to -.82). Ten studies further reported that SBI was associated with decreases in specific areas of cognitive function.
CONCLUSIONS
These results suggest that rather than being clinically silent, SBI might be a factor inducing cognitive dysfunction.
背景与目的
既往一直被认为临床无症状的脑梗死（SBI），已被提出作为未来认知功能下降的亚临床风险标志物。
方法
我们在考克兰图书馆、医学期刊数据库、荷兰医学文摘数据库和中国知网数据库中对文献进行了系统评价。
结果
最终，19项病例对照研究（共6712名参与者）和3项前瞻性队列研究（共4433名参与者）符合所有纳入标准并被纳入该系统评价。对9项研究的荟萃分析表明，SBI是认知功能下降（简易精神状态评分）的一个重要因素（标准化均差为-0.47，95%置信区间为-0.72至-0.22）。对4项研究的另一项荟萃分析报告称，SBI是认知功能障碍（蒙特利尔认知评估量表）的一个独立因素（标准化均差为-3.36，95%置信区间为-5.90至-0.82）。10项研究进一步报告称，SBI与特定认知功能领域的下降有关。
结论
这些结果表明，SBI可能并非临床无症状，而是诱导认知功能障碍的一个因素。
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