Association between splenectomy and chronic thromboembolic pulmonary hypertension: a systematic review and meta-analysis.
Association between splenectomy and chronic thromboembolic pulmonary hypertension: a systematic review and meta-analysis.
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脾切除术与慢性血栓栓塞性肺动脉高压之间的关联：系统评价和荟萃分析
DOI：
10.1136/bmjopen-2020-038385
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发表时间：
2021-02-23
期刊：
影响因子：
2.9
通讯作者：
Zhang M
中科院分区：
文献类型：
--
作者：
Zhang L;Yan P;Yang K;Wu S;Bai Y;Zhu X;Chen X;Li L;Cao Y;Zhang M
脾切除术是否会增加慢性血栓栓塞性肺动脉高压（CTEPH）的风险尚不清楚。我们进行了一项系统回顾和荟萃分析，以探讨脾切除术与CTEPH之间的关系。系统回顾和荟萃分析. PubMed、Embase和科克伦图书馆数据库。两位作者独立检索和提取数据。采用Newcastle-Ottawa量表和加强流行病学观察性研究报告指南评估纳入研究的质量，每个质量项目分为低风险和高风险。使用随机效应模型计算不同的有效值。共有8项试验（涉及6183名受试者）符合纳入标准。CTEPH患者中脾切除术的总体汇总粗患病率为4.0%（95% CI 0.03 - 0.06，I2= 71.5%，p<0.001）。亚组分析显示，与肺动脉高压患者相比，CTEPH患者的脾切除术发生率在统计学上显著较高（OR=2.94，95% CI 1.62 - 5.33，I2= 0.0%，p<0.001）。与血栓栓塞性疾病（静脉血栓栓塞或肺栓塞）患者相比，CTEPH患者的脾切除术发生率显著较高（OR=5.59，95% CI 2.12 - 14.74，I2= 0.0%，p<0.001）。CTEPH患者脾切除的发生率为4.0%，CTEPH可能与脾切除有关。然而，需要高质量的前瞻性试验。CRD 42020137591。
Whether splenectomy increases the risk of chronic thromboembolic pulmonary hypertension (CTEPH) remains unclear. We conducted a systematic review and meta-analysis to explore the association between splenectomy and CTEPH. Systematic review and meta-analysis. PubMed, Embase and Cochrane Library databases. Two authors independently searched and extracted the data. The Newcastle-Ottawa Scale and the Strengthening the Reporting of Observational Studies in Epidemiology guidelines were used to assess the quality of the included studies, and each quality item was graded as low risk or high risk. A random-effects model was used to calculate different effective values. In total, 8 trials involving 6183 participants fulfilled the inclusion criteria. The overall pooled crude prevalence of splenectomy was 4.0% (95% CI 0.03 to 0.06, I2=71.5%, p<0.001) in patients with CTEPH. Subgroup analysis showed a statistically significant high incidence of splenectomy in patients with CTEPH (OR=2.94, 95% CI 1.62 to 5.33, I2=0.0%, p<0.001) compared with patients with pulmonary arterial hypertension. There was a significantly high incidence of splenectomy in patients with CTEPH (OR=5.59, 95% CI 2.12 to 14.74, I2=0.0%, p<0.001) compared with patients with thromboembolism disease (venous thromboembolism or pulmonary embolism). The prevalence of splenectomy in patients with CTEPH was 4.0% and CTEPH might be associated with splenectomy. However, high-quality prospective trials are needed. CRD42020137591.
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