本文選題：眼底 + 腦白質(zhì)病變��； 參考：《山西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的系統(tǒng)評(píng)價(jià)眼底血管異常與缺血性腦白質(zhì)病變（WMLs）的關(guān)系。 方法計(jì)算機(jī)檢索Cochrane圖書館(2013年第四期)、Medline(1950年－2013年)、Embase(1980年－2013年)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBMdisc，1978年－2013年)、中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(CNKI，1979年－2013年)、中文科技期刊全文數(shù)據(jù)庫(VIP，1989年－2013年)、萬方數(shù)據(jù)庫(1978年－2013年)、中文生物醫(yī)學(xué)會(huì)議文獻(xiàn)數(shù)據(jù)庫(CMCA，1994年－2013年)等，收集國(guó)內(nèi)外有關(guān)眼底血管異常與缺血性腦白質(zhì)病變的病例對(duì)照研究。按Cochrane系統(tǒng)評(píng)價(jià)的方法，由兩名研究者獨(dú)立的進(jìn)行質(zhì)量評(píng)價(jià)和資料提取，對(duì)文獻(xiàn)研究結(jié)果進(jìn)行Meta分析、定性評(píng)價(jià)以及倒漏斗圖分析等。在Meta分析過程中應(yīng)用Cochrane協(xié)作網(wǎng)提供的RevMan5.2軟件進(jìn)行，依據(jù)異質(zhì)性檢驗(yàn)的結(jié)果選擇固定效應(yīng)模型或隨機(jī)效應(yīng)模型，檢驗(yàn)水準(zhǔn)為α=0.05，估計(jì)綜合評(píng)價(jià)指標(biāo)的95%可信區(qū)間。 結(jié)果共納入4篇文獻(xiàn)，樣本量為2159例，，其中病例組（WMLs組）495例，對(duì)照組（非WMLs組）1664例。存在眼底血管異常的人患WMLs的危險(xiǎn)性是未暴露此因素者的2.98倍[OR=2.98,95%CI（2.23，3.99），P0.00001]。綜合本研究所納入的文獻(xiàn)，共有的眼底血管異常指標(biāo)包括：動(dòng)靜脈交叉征、動(dòng)脈狹窄、滲出、眼底出血及微動(dòng)脈瘤。存在動(dòng)靜脈交叉征者患WMLs的危險(xiǎn)性是未暴露此因素（動(dòng)靜脈交叉征）者的2.26倍[OR=2.26,95%CI（1.70，3.00），P0.00001]；存在眼底動(dòng)脈狹窄者患WMLs的危險(xiǎn)性是未暴露此因素（動(dòng)脈狹窄）者的2.37倍[OR=2.37,95%CI（1.70，3.28），P0.00001]；存在滲出者患WMLs的危險(xiǎn)性是未暴露此因素（滲出）者的2.52倍[OR=2.52,95%C（I1.56，4.07），P=0.0002]；存在眼底出血者患WMLs的危險(xiǎn)性是未暴露此因素（出血）者的2.55倍[OR=2.55,95%CI（1.51，4.30），P=0.0004]；微動(dòng)脈瘤[OR=1.56,95%CI（0.36，6.72），P=0.55]對(duì)WMLs發(fā)生的影響無統(tǒng)計(jì)學(xué)意義。 結(jié)論眼底血管異常增加了WMLs發(fā)生的危險(xiǎn)性；眼底血管異常的觀察指標(biāo)中動(dòng)靜脈交叉征、動(dòng)脈狹窄、眼底出血及滲出均與WMLs的發(fā)生有關(guān)，微動(dòng)脈瘤對(duì)WMLs發(fā)生的影響無統(tǒng)計(jì)學(xué)意義。
[Abstract]:Objective to evaluate the relationship between fundus vascular abnormalities and ischemic white matter lesions (WMLs). Methods the Cochrane Library (fourth issue of Medline, 1950-2013, 1980-2013, China Biomedical Literature Database, 1978-2013, China academic Journal Full-text Database, 1979-2013, VIP1989, China academic Journal Full-text Database) was searched by computer. -2013, Wanfang database (1978-2013, CMCA, 1994-2013), etc. Case-control study of abnormal fundus vessels and ischemic leukoencephalopathy at home and abroad was collected. According to the method of Cochrane system evaluation, two researchers independently carried out quality evaluation and data extraction, and carried out Meta analysis, qualitative evaluation and inverted funnel map analysis on the results of literature research. In the process of Meta analysis, the RevMan5.2 software provided by Cochrane cooperation network is used. According to the results of heterogeneity test, the fixed effect model or random effect model is selected. The test level is 偽 -0.05, and the 95% confidence interval of the comprehensive evaluation index is estimated. Results A total of 4 articles were included, with a sample size of 2159 cases, including 495 cases in the WMLs group and 1 664 cases in the control group (non-WMLs group). People with abnormal fundus vessels were 2.98 times more likely to develop WMLs than those without exposure. According to the literature, the common indicators of ocular fundus vascular abnormalities include arteriovenous cross sign, arterial stenosis, exudation, fundus hemorrhage and microaneurysm. The risk of WMLs in patients with arteriovenous cross syndrome was 2.26 times as high as that in those with no exposure (arteriovenous cross syndrome) [OR2.2695 CII 1.70 3.00 P0.00001]; the risk of WMLs in patients with ophthalmic artery stenosis was 2.37 times as high as that in unexposed patients [OR2.3795CI1.703.28] and the risk of WMLs was 2.37 times as high as that of non-exposed patients [OR2.3795CI1.703.28 / P0.00001], and the risk of WMLs in patients with arteriovenous artery stenosis was 2.37 times higher than that in patients with non-exposed arteriovenous cross syndrome (AVM). The risk of WMLs in exudators was 2.52 times as high as that in those not exposed (exudation). The risk of WMLs in patients with fundus hemorrhage was 2.55 times higher than that in those without exposure (bleeding). There was no statistical significance in the influence of arterioaneurysm [OR1.5695CI0.36.72P0.55] on the occurrence of WMLs. Conclusion the abnormal fundus vessels increase the risk of WMLs, the arteriovenous cross sign, arterial stenosis, fundus hemorrhage and exudation are all related to the occurrence of WMLs, and the influence of microaneurysm on the occurrence of WMLs is not statistically significant.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R742

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本文編號(hào)：1923790