目的 系统评价妊娠期脑动静脉畸形(cerebral arteriovenous malformation,CAVM)出血的发生风险.方法 计算机检索 Web of Science、PubMed、Cochrane Library、WanFang Data、VIP 和 CNKI 数据库,搜集妊娠期合并CAVM出血的临床研究,检索时限均从建库至2023年6月.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后,采用Stata 13.1和R 4.0.4软件进行Meta分析.结果 共纳入13个研究,包括2273例患者.Meta分析结果显示:妊娠发生CAVM出血的合并发病率为0.18[95％CI(0.12,0.24)].亚组分析显示:欧洲地区的研究妊娠发生CAVM出血的发病率较高,为0.37[95％CI(0.05,0.80)];10～20年期的研究发病率较高,为0.37[95％CI(0.17,0.57)].结论 当前证据显示,妊娠发生CAVM出血的合并发病率约为18％.受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证.
Risk of hemorrhage in pregnant cerebral arteriovenous malformation patients:a systematic review
Objective To systematically review the risk of hemorrhage in pregnant cerebral arteriovenous malformation(CAVM)patients.Methods The Web of Science,PubMed,Cochrane Library,WanFang Data,VIP and CNKI databases were electronically searched to collect clinical studies related to hemorrhage in pregnant CAVM patients from inception to June,2023.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was then performed by using Stata 13.1 and R 4.0.4 software.Results A total of 13 studies involving 2 273 patients were included.The results of meta-analysis showed that the pooled incidence of hemorrhage in pregnant CAVM patients was 0.18(95％CI 0.12 to 0.24).The subgroup analyses were carried out based on world regions and the study duration,with the higher pooled incidence of 0.37(95％CI 0.05 to 0.80)in Europe and 10 to 20 years of study duration of 0.37(95％CI 0.17 to 0.57).Conclusion Current evidence shows that the incidence of hemorrhage in pregnant CAVM patients is about 18％.Due to the limited quality and quantity of the included studies,more high quality studies are needed to verify the above conclusion.
万方数据
维普
