中国全科医学2024,Vol.27Issue(3) :364-374.DOI:10.12114/j.issn.1007-9572.2023.0414

中国卒中后疲劳患病率及发展趋势的Meta分析

Prevalence and Trends for Post-stroke Fatigue in China:a Meta-analysis

薛超 李娟 方茜 余洁 郝明青
中国全科医学2024,Vol.27Issue(3) :364-374.DOI:10.12114/j.issn.1007-9572.2023.0414

中国卒中后疲劳患病率及发展趋势的Meta分析

Prevalence and Trends for Post-stroke Fatigue in China:a Meta-analysis

薛超 1李娟 2方茜 2余洁 1郝明青1
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作者信息

  • 1. 550002 贵州省贵阳市,贵州中医药大学护理学院
  • 2. 550002 贵州省贵阳市,贵州省人民医院护理部
  • 折叠

摘要

背景 卒中后疲劳(PSF)严重影响患者预后恢复,也是卒中复发和卒中后死亡的独立危险因素.了解PSF的流行病学现状对于推进我国卒中防治工作具有重要意义.目的 系统评价中国PSF患病现状及发展趋势,为我国相关部门制订有针对性地脑卒中防治策略提供参考依据.方法 计算机检索PubMed、Web of Science、Embase、中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、维普网(VIP)和中国生物医学文献数据库(CBM),搜集有关中国PSF患病率的横断面研究,检索时限均从建库至 2023-05-20.由 2 名研究者独立筛选文献,提取资料并评价纳入研究的偏倚风险,采用Stata 16.0 软件进行Meta分析.结果 共纳入 57 个横断面研究,涉及中国 19 个省/自治区/直辖市及特别行政区,总样本量为 13 621 例,其中PSF者 5 764 例.Meta分析结果显示,我国PSF患病率为43.5%(95%CI=40.0%~47.0%).亚组分析结果显示,按性别分组,男性患病率为38.4%(95%CI=34.3%~42.5%),女 性 为 45.2%(95%CI=40.7%~49.7%);按 年 龄 分 组,<60 岁 为 40.0%(95%CI=32.3%~48.0%),60~75 岁 为67.9%(95%CI=54.2%~80.1%),>75 岁为 71.9%(95%CI=48.9%~90.5%);按地理分区分组,华北地区为 40.0%(95%CI=35.0%~45.2%),东北地区为41.0%(95%CI=29.5%~53.0%),华东地区为49.5%(95%CI=43.1%~55.8%),华中地区为 40.3%(95%CI=34.9%~45.8%),华南地区为 40.0%(95%CI=28.4%~52.2%),西南地区为 59.3%(95%CI=54.0%~65.0%),西北地区为 46.2%(95%CI=38.3%~54.2%);按卒中性质分组,出血性脑卒中为 56.3%(95%CI=42.8%~69.4%),缺血性脑卒中为 40.0%(95%CI=36.7%~43.4%);按卒中分期分组,急性期为 41.4%(95%CI=37.0%~45.8%),恢复期为 46.4%(95%CI=40.8%~52.1%);按受教育程度分组,小学及以下为 56.0%(95%CI=43.7%~67.9%),初中为 46.7%(95%CI=39.6%~53.8%),高中为 46.8%(95%CI=40.3%~53.4%),大专及以上为 43.6%(95%CI=35.7%~51.6%);按婚姻状况分组,有配偶者为 45.8%(95%CI=40.8%~50.9%),无配偶者为53.6%(95%CI=47.4%~59.8%);按工作状况分组,在职者为 45.0%(95%CI=33.2%~57.0%),无业或退休者为 53.8%(95%CI=40.1%~67.2%);按评估工具分组,应用疲劳严重程度量表(FSS)为 41.8%(95%CI=38.3%~45.3%),应用个人疲劳强度问卷(CIS)为 65.8%(95%CI=57.1%~74.0%),应用中文版卒中神经疲劳指数(NFI-stroke)为 50.5%(95%CI=44.6%~56.5%),应用中文版疲劳评估量表(C-FAS)为 52.7%(95%CI=43.1%~62.1%),应用精神疲劳自评量表(MFS)为 48.9%(95%CI=43.6%~54.2%).此外,从年龄分布来看,我国PSF患病率随年龄增长而逐渐增加(χ2 趋势=87.081,r=0.209,P<0.01);从文化背景来看,我国PSF患病率与受教育程度的无相关趋势(χ2 趋势= 0.333,P=0.564);从空间分布来看,全国7个地区PSF患病率(40.0%~59.3%)间差异有统计学意义(χ2=122.615,P<0.01),19个省级行政区PSF患病率(23.3%~74.2%)间差异有统计学意义(χ2=504.294,P<0.01);从发表时间来看,2013 年 1 月—2023 年 5 月我国PSF患病率(32.4%~53.9%)有增长趋势(χ2 趋势=48.011,P<0.01).结论 中国PSF总体患病率较高,不同地区、省份之间存在明显差异,其中西南地区和贵州省最高,而华北地区、华南地区及天津市最低.此外,女性、高龄、无配偶、受教育程度低、无业或退休、卒中恢复期、脑出血等群体PSF患病率偏高.

Abstract

Background Post-stroke fatigue(PSF)has a significant impact on patients'prognostic recovery and is an independent risk factor for stroke recurrence and post-stroke death.Therefore,understanding the current epidemiological status of PSF is of great significant in promoting stroke prevention and treatment in China.Objective To systematically evaluate the current situation and development trend of PSF in China,in order to provide a reference basis for the relevant departments to formulate targeted stroke prevention and treatment strategies.Methods PubMed,Web of Science,Embase,CNKI,Wanfang Data,VIP,and CBM were searched by computer to collect cross-sectional studies on the prevalence of PSF in China from inception to 2023-05-20.Meta-analysis was performed using Stata 16.0 software after 2 investigators independently screened the literature,extracted information and evaluated the risk of bias of the included studies.Results A total of 57 cross-sectional studies involving 19 provinces/autonomous regions/municipalities directly under the central government and special administrative regions of China,with a total sample size of 13 621 individuals,including 5 764 individuals with PSF.Meta-analysis showed that the prevalence of PSF in China was 43.5%(95%CI=40.0%-47.0%).The results of subgroup analysis showed that the prevalence was 38.4%(95%CI=34.3%-42.5%)for men and 45.2%(95%CI=40.7%-49.7%)for women by gender grouping;the prevalence was 40.0%(95%CI=32.3%-48.0%)for those under 60 years of age,67.9%(95%CI=54.2%-80.1%)for those aged 60-75 years by age grouping and 71.9%(95%CI=48.9%-90.5%)for those aged 75 years and above;the prevalence was 40.0%(95%CI=35.0%-45.2%)in North China,41.0%(95%CI=29.5%-53.0%)in Northeast China,49.5%(95%CI=43.1%-55.8%)in East China,40.3%(95%CI=34.9%-45.8%)in Central China,40.0%(95%CI=28.4%-52.2%)in South China,59.3%(95%CI=54.0%-65.0%)in Southwest China,and 46.2%(95%CI=38.3%-54.2%)in Northwest China by regional grouping;the prevalence was 56.3%(95%CI=42.8%-69.4%)for hemorrhagic stroke and 40.0%(95%CI=36.7%-43.4%)for ischemic stroke by stroke nature grouping;the prevalence was 41.4%(95%CI=37.0%-45.8%)for acute phase and 46.4%(95%CI=40.8%-52.1%)for recovery phase by stroke duration grouping;the prevalence was 56.0%(95%CI=43.7%-67.9%)for elementary school and below,46.7%(95%CI=39.6%-53.8%)for junior high school,46.8%(95%CI=40.3%-53.4%)for senior high school,and 43.6%(95%CI=35.7%-51.6%)for college and above by education level grouping;the prevalence was 45.8%(95%CI=40.8%-50.9%)for those with a spouse and 53.6%(95%CI=47.4%-59.8%)for those without a spouse by marital status;the prevalence was 45.0%(95%CI=33.2%-57.0%)for those who were employed and 53.8%(95%CI=40.1%-67.2%)for those who were unemployed or retired by work status grouping;the prevalence was 41.8%(95%CI=38.3%-45.3%)for those who applied the Fatigue Severity Scale(FSS),65.8%(95%CI=57.1%-74.0%)for those who applied the Check List Individual Strength(CIS),50.5%(95%CI=44.6%-56.5%)for those who applied the Chinese version of the Neurological Fatigue Index for Stroke(NFI-stroke),52.7%(95%CI=43.1%-62.1%)for those who applied the Chinese version of the Fatigue Assessment Scale(C-FAS),and 48.9%(95%CI=43.6%-54.2%)for those who applied the Mental Fatigue Self-Rating Scale(MFS).Additionally,in terms of age distribution,the prevalence of PSF in China increased gradually with age(χ2trend=87.081,r=0.209,P<0.01);in terms of cultural background,the trend of correlation between the prevalence of PSF in China and education level was not statistically significant(χ2trend=0.333,P=0.564);and in terms of spatial distribution,the prevalence of PSF(40.0%-59.3%)varied significantly among the seven regions of the country(χ2=122.615,P<0.01),and the prevalence of PSF(23.3%-74.2%)also varied significantly among 19 provincial-level administrative regions in China(χ2=504.294,P<0.01);from the perspective of the publication time,the prevalence of PSF in China fluctuated in 32.4%to 53.9%from January 2013 to May 2023(χ2trend=48.011,P<0.01).Conclusion The results of this study have shown a high overall prevalence of PSF in China,with significant differences among regions and provinces.The highest prevalence was found in Southwest China and Guizhou Province,whereas the lowest prevalence was observed in North China,South China,and Tianjin City.Additionally,PSF was found to be more prevalent among certain groups,including females,advanced age,no spouse,low education level,unemployed or retired work status,recovery phase of stroke,and hemorrhagic stroke.

关键词

脑卒中/疲劳/患病率/发展趋势/Meta分析/系统评价/中国

Key words

Stroke/Fatigue/Prevalence/Development trends/Meta-analysis/Systematic review/China

引用本文复制引用

基金项目

国家自然科学基金资助项目(72364005)

贵州省中医药管理局中医药、民族医药科学技术课题研究资助(QZYY-2023-115)

贵州省卫生健康委员会科学技术基金(gzwkj2021-476)

出版年

2024
中国全科医学
中国医院协会

中国全科医学

CSTPCD北大核心
影响因子:2.04
ISSN:1007-9572
参考文献量86
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