颅脑损伤患者轻度认知功能障碍影响因素的Meta分析

doi:10.3761/j.issn.2096-7446.2023.03.015

Abstract

Abstract: Objective To identify the risk factors of mild cognitive impairment in patients with traumatic brain injury by meta-analysis. Methods China National Knowledge Network,Wanfang Database,China Biomedical Literature Database,PubMed,Embase,Cochrane Library and other databases were searched for studies on mild cognitive impairment in patients with craniocerebral injury from the establishment of the database to August 2022 and the references of included studies were included. Two reviewers screened the literature according to the inclusion and exclusion criteria,and extracted data,assessed the quality of included studies independently. Meta-analysis was conducted by Rev Man 5.3. Results A total of 17 studies and 16 risk factors were included,with a sample size of 11 750 cases. The meta-analysis result showed that the risk factors were age（OR=3.03）,education level（OR=2.46）,damage of frontal lobe（OR=4.84）,damage of temporal lobe（OR=6.01）,damage of left hemisphere（OR=5.02）,multi-site injury（OR=6.80）. Conclusion Clinical nursing staff should strengthen the assessment and screening of cognitive impairment in patients with brain injury,pay attention to the potential impact of cognitive reserve（age and education level）and the characteristics of different damaged areas of cognitive domain,target early and effective intervention to improve the clinical outcome of patients.

Key words: Craniocerebral Trauma, Cognition Disorders, Factor Analysis, Statistical, Critical Care Nursing, Meta-Analysis as Topic

ZHANG Yazhi, LI Chunlin, LIU Yuanyuan, HUANG Zhao. Meta-analysis of influencing factors of mild cognitive impairment in patients with traumatic brain injury[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(3): 263-269.

References

[1] 金铂,陈盈宇,曹梦琢,等. 轻型创伤性颅脑损伤患者并发脑震荡后综合征的临床特点及其相关因素分析[J]. 中华神经医学杂志,2019,18(6):570-574.
Jin B,Chen YY,Cao MZ,et al.Clinical features and risk factors of post-concussion syndromes after mild traumatic brain injury[J]. Chin J Neuromed,2019,18(6):570-574.
[2] 贾耀辉,陈慧敏,代永庆,等. 超早期颅骨修补对颅脑损伤术后颅骨缺损患者认知功能及脑血管反应性的影响[J]. 国际精神病学杂志,2017,44(3):516-518,535.
Jia YH,Chen HM,Dai YQ,et al.Effect of ultra-early skull repair on the cognitive function and cerebrovascular reactivity in patients with skull defects after craniocerebral injury operation[J]. J Int Psychiatry,2017,44(3):516-518,535.
[3] 中国老年医学学会认知障碍分会,认知障碍患者照料及管理专家共识撰写组. 中国认知障碍患者照料管理专家共识[J]. 中华老年医学杂志,2016,35(10):1051-1060.
Writing Group of Expert Consensus on Long-term Healthcare of Cognitive Disorders in China, Academy of Cognitive Disorder of China(ACDC). Expert consensus on long-term healthcare of patients with cognitive disorders in China[J]. Chin J Geriatr,2016,35(10):1051-1060.
[4] 庄丽英,赖其伦,刘璐,等. Framingham风险评分对中老年轻度认知障碍患者进展为痴呆的预测价值[J]. 中华老年病研究电子杂志,2021,8(3):20-23.
Zhuang LY,Lai QL,Liu L,et al.The predictive value of Framingham Risk Score for mild cognitive impairment progress to dementia in middle-aged and elderly patients[J]. Chin J Geriatr Res Electron Ed,2021,8(3):20-23.
[5] 焦黛妍,邓海鹏,顾和燕,等. 针刺联合重复经颅磁刺激对颅脑损伤后认知障碍的影响[J]. 国际中医中药杂志,2021,43(11):1076-1079.
Jiao DY,Deng HP,Gu HY,et al.Clinical study of acupuncture combined with repetitive transcranial magnetic stimulation in the treatment of cognitive impairment after traumatic brain injury[J]. Int J Tradit Chin Med,2021,43(11):1076-1079.
[6] 熊学辉,瞿丹霞. 轻中型颅脑损伤继发轻度认知功能障碍危险因素分析[J]. 中国神经精神疾病杂志,2016,42(1):40-44.
Xiong XH,Qu DX.Analysis the risk factors of the mild cognitive impairment secondary with the mild to moderate traumatic brain injury patients[J]. Chin J Nerv Ment Dis,2016,42(1):40-44.
[7] 勾爱香. 颅脑损伤患者认知障碍发生的影响因素[J]. 临床医学,2022,42(9):55-57.
Gou AX.Influencing factors of cognitive impairment in patients with craniocerebral injury[J]. Clin Med,2022,42(9):55-57.
[8] Stang A.Critical evaluation of the Newcastle-Ottawa Scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. Eur J Epidemiol,2010,25(9):603-605.
[9] Stenberg J,Håberg AK,Follestad T,et al.Cognitive reserve moderates cognitive outcome after mild traumatic brain injury[J]. Arch Phys Med Rehabil,2020,101(1):72-80.
[10] Han CY,Yang Y,Ruan SL,et al.The predictive value of serum p-CREB level on secondary cognitive impairment in patients with mild-to-moderate craniocerebral trauma[J]. Neurosurg Rev,2019,42(3):715-720.
[11] LoBue C,Denney D,Hynan LS,et al. Self-reported traumatic brain injury and mild cognitive impairment:increased risk and earlier age of diagnosis[J]. J Alzheimers Dis,2016,51(3):727-736.
[12] Zatzick DF,Rivara FP,Jurkovich GJ,et al.Multisite investigation of traumatic brain injuries,posttraumatic stress disorder,and self-reported health and cognitive impairments[J]. Arch Gen Psychiatry,2010,67(12):1291-1300.
[13] Wong GK,Ngai K,Wong A,et al. Long-term cognitive dysfunction in patients with traumatic subarachnoid hemorrhage:prevalence and risk factors[J]. Acta Neurochir(Wien),2012,154(1):105-111;discussion111.
[14] 邬树凯,陈峻严,高宏志,等. 重型创伤性颅脑损伤后认知功能障碍特征及其影响因素的初步研究[J]. 中国医师进修杂志, 2011,34(29):26-29.
Wu SK,Chen JY,Gao HZ,et al.The preliminary research on the characteristics of cognitive function and its related factors in patients with severe traumatic brain injury[J]. Chin J Postgrad Med,2011,34(29):26-29.
[15] 胡朝帅,金保哲,张新中. 中型创伤性颅脑损伤后认知障碍的现状及影响因素分析[J]. 中国卫生标准管理,2018,9(7):47-50.
Hu CS,Jin BZ,Zhang XZ.The Current status and influential factors of cognitive impairment after moderate traumatic brain injury[J]. China Heal Stand Manag,2018,9(7):47-50.
[16] 黄从刚,段发亮,吴京雷,等. 血清NSE水平对轻中度颅脑损伤患者继发轻度认知功能障碍的预测价值[J]. 中华神经医学杂志,2017,16(5):513-518.
Huang CG,Duan FL,Wu JL,et al.Predictive value of neuron-specific enolase in patients with mild cognitive impairment secondary to mild,moderate craniocerebral injury[J]. Chin J Neuromed,2017,16(5):513-518.
[17] 程晓涛,金保哲,惠磊,等. 轻中度颅脑损伤患者认知功能障碍特征及危险因素[J]. 中华脑科疾病与康复杂志(电子版),2016,6(1):25-28.
Cheng XT,Jin BZ,Hui L,et al.Characteristics and risk factors of cognitive dysfunction in patients with mild and moderate traumatic brain injury[J]. Chin J Brain Dis Rehabil Electron Ed,2016,6(1):25-28.
[18] 邬树凯. 急性颅脑创伤后Aβ相关蛋白表达与认知功能障碍特征相关机制的初步研究[D]. 福州:福建医科大学,2011.
Wu SK.The preliminary research on the characteristics of the cognitive function and its aβ-related mechanism in patients with acute traumatic brain injury[D]. Fuzhou:Fujian Medical University,2011.
[19] 童武松,郭义君,杨文进,等. 急性创伤性脑损伤后早期认知功能障碍特征及影响因素分析[J]. 中华创伤杂志,2015,31(2):128-132.
Tong WS,Guo YJ,Yang WJ,et al.Characteristics and associated factors of early cognitive dysfunction following acute traumatic brain injury[J]. Chin J Traumatol,2015,31(2):128-132.
[20] 熊俊,周青山. 颅脑损伤患者损伤部位与继发血管性痴呆的相关性研究[J]. 现代中西医结合杂志,2016,25(10):1050-1053.
Xiong J,Zhou QS.Study on the correlation between brain injury portions with secondary vascular dementia in patients with brain injury patients[J]. Mod J Integr Tradit Chin West Med,2016,25(10):1050-1053.
[21] 董立焕,刘萍萍,王卫亮,等. 脑损伤急性应激障碍患者轻度认知障碍的影响因素[J]. 中国健康心理学杂志,2019,27(5):641-645.
Dong LH,Liu PP,Wang WL,et al.The influencing factors of mild cognitive impairment patients with acute stress disorder of brain injury[J]. China J Heal Psychol,2019,27(5):641-645.
[22] 王宏任,王知非. 中型颅脑损伤后认知障碍的影响因素分析[J]. 中华神经外科杂志,2019,35(11):1143-1147.
Wang HR,Wang ZF.Analysis of influencing factors of cognitive impairment after moderate traumatic brain injury[J]. Chin J Neurosurg,2019,35(11):1143-1147.
[23] 李鹏强,单春格. 颅脑外伤患者认知功能障碍的危险因素调查[J]. 国际精神病学杂志,2020,47(3):547-549,556.
Li PQ,Shan CG.Risk factors of cognitive dysfunction in patients with traumatic brain injury[J]. J Int Psychiatry,2020,47(3):547-549,556.
[24] 张弢,孙涛,张少军. Logistic回归与人工神经网络应用于重度颅脑损伤继发认知功能障碍的预测评判[J]. 齐齐哈尔医学院学报,2019,40(9):1073-1078.
Zhang T,Sun T,Zhang SJ.Application of logistic regression and artificial neural network in predictive evaluation of secondary cognitive impairment in severe traumatic brain injury[J]. J Qiqihar Med Univ,2019,40(9):1073-1078.
[25] 栾丽芹. 急性脑梗死后认知功能障碍的相关危险因素分析[J]. 中国实用神经疾病杂志,2015,18(3):45-47.
Luan LQ.Analysis of the risk factors of cognitive impairment after ischemic stroke[J]. Chin J Pract Neruous Dis,2015,18(3):45-47.
[26] 赵连生,王英成,韦锦学,等. 性别、年龄、教育年限及多巴胺受体4基因多态性与成人认知功能的关联研究[J]. 中华医学遗传学杂志,2015,32(3):391-394.
Zhao LS,Wang YC,Wei JX,et al.Association of gender, age, education and polymorphism of DRD4 gene with cognitive functions in adults[J]. Chin J Med Genet,2015,32(3):391-394.
[27] Andrews RN,Metheny-Barlow LJ,Peiffer AM,et al.Cerebrovascular remodeling and neuroinflammation is a late effect of radiation-induced brain injury in non-human Primates[J]. Radiat Res,2017,187(5):599-611.
[28] 刘林燚,王忠义,马俊. 中重度创伤性颅脑损伤病人认知功能受损特点[J]. 中国微侵袭神经外科杂志,2015,20(11):501-503.
Liu LY,Wang ZY,Ma J.Characteristics of cognitive impairment after moderate-to-severe traumatic brain injury[J]. Chin J Minim Invasive Neurosurg,2015,20(11):501-503.
[29] 刘伯源,王久玲,肖义泽. 中国60岁及以上人群老年期痴呆患病率Meta分析[J]. 中华流行病学杂志,2016,37(11):1541-1545.
Liu BY,Wang JL,Xiao YZ.Prevalence of senile dementia in people aged ≥60 years in China:a Meta-analysis[J]. Chin J Epidemiol,2016,37(11):1541-1545.
[30] Stern Y.Cognitive reserve in ageing and Alzheimer's disease[J]. Lancet Neurol,2012,11(11):1006-1012.
[31] 许琼冠. 不同部位损伤对颅脑外伤病人认知功能的影响[J]. 安徽医药,2019,23(3):540-542.
Xu QG.Effects of different parts injury on cognitive function in patients with craniocerebral trauma[J]. Anhui Med Pharm J,2019,23(3):540-542.
[32] 龚文苹,丁美萍,郭起浩,等. 四种不同脑部位卒中后认知功能状况比较[J]. 中华医学杂志,2011,91(27):1904-1908.
Gong WP,Ding MP,Guo QH,et al.A comparison study on cognitive function in patients with single subcortical lesion stroke of four different areas[J]. Natl Med J China,2011,91(27):1904-1908.
[33] Plaschke K,Hauth S,Jansen C,et al.The influence of preoperative serum anticholinergic activity and other risk factors for the development of postoperative cognitive dysfunction after cardiac surgery[J]. J Thorac Cardiovasc Surg,2013,145(3):805-811.

Meta-analysis of influencing factors of mild cognitive impairment in patients with traumatic brain injury

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