系统评价和荟萃分析亚洲人群腹主动脉瘤的患病率。
Systematic review and meta-analysis of the prevalence of abdominal aortic aneurysm in Asian populations.
机构信息
Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore.
Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore.
出版信息
J Vasc Surg. 2021 Mar;73(3):1069-1074.e1. doi: 10.1016/j.jvs.2020.08.140. Epub 2020 Sep 26.
OBJECTIVE
The prevalence of abdominal aortic aneurysms (AAAs) is well reported in Western countries and AAA screening programs are well-established. However, although individual studies have reported that the prevalence of AAAs is lower in Asian populations, high-quality data on the prevalence of AAA in Asians are relative lacking. The present study aimed to systematically synthesize the data available in the literature and report the prevalence of AAAs in Asians.
METHODS
An electronic search was performed using two major databases (PubMed and EMBASE) with no limitations imposed on the year of publication. The review conformed to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Studies that reported the prevalence of AAAs in Asians were selected, and the population characteristics, AAA definition, method of screening, target population, and total number of patients screened were recorded.
RESULTS
Our search yielded 157 unique articles. After a full-text review, 17 articles were included in the present study. All 17 studies of fair quality. The overall AAA prevalence was 1.30% (95% confidence interval [CI], 1.01%-1.59%) in Asian populations. The prevalence of AAAs was 2.56% (95% CI, 1.81%-3.31%) in Asian populations selected for cardiovascular risk factors and 0.61% (95% CI, 0.37%-0.85%) in Asian populations not selected for cardiovascular risk factors.
CONCLUSIONS
The prevalence of AAAs in the general Asian population is low. However, the prevalence in Asian populations selected for cardiovascular risk factors approaches the prevalence of AAAs in Western populations. As such, screening for AAAs in carefully selected Asian male populations with cardiovascular risk factors could potentially yield benefits. Opportunistic screening for AAAs during ultrasound examination of the abdomen or transthoracic echocardiography for other indications could also be considered. However, further studies are needed to evaluate the potential benefits of screening for AAAs in carefully selected Asian populations.
目的
西方国家对腹主动脉瘤（AAA）的患病率有详细的报道，AAA 筛查计划也已建立。然而，尽管个别研究报告称亚洲人群 AAA 的患病率较低，但高质量的亚洲人群 AAA 患病率数据相对缺乏。本研究旨在系统地综合文献中的现有数据，并报告亚洲人群 AAA 的患病率。
方法
使用两个主要数据库（PubMed 和 EMBASE）进行电子检索，对发表年份没有限制。本综述符合 PRISMA（系统评价和荟萃分析的首选报告项目）指南。选择报告亚洲人群 AAA 患病率的研究，并记录研究的人群特征、AAA 定义、筛查方法、目标人群和筛查的总患者人数。
结果
我们的搜索产生了 157 篇独特的文章。经过全文审查，有 17 篇文章被纳入本研究。所有 17 项研究的质量均为中等。亚洲人群的总体 AAA 患病率为 1.30%（95%置信区间[CI]，1.01%-1.59%）。在选择心血管危险因素的亚洲人群中，AAA 的患病率为 2.56%（95%CI，1.81%-3.31%），而在未选择心血管危险因素的亚洲人群中，AAA 的患病率为 0.61%（95%CI，0.37%-0.85%）。
结论
亚洲普通人群中 AAA 的患病率较低。然而，在选择心血管危险因素的亚洲人群中，AAA 的患病率接近西方人群。因此，在具有心血管危险因素的精心挑选的亚洲男性人群中筛查 AAA 可能具有潜在的益处。在进行腹部超声检查或经胸超声心动图检查其他适应症时，也可以考虑机会性筛查 AAA。然而，需要进一步的研究来评估在精心挑选的亚洲人群中筛查 AAA 的潜在益处。
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