系统性炎症反应综合征与急性脑出血不良结局：一项荟萃分析。
完整摘要 · 中文译文
目的：全身炎症反应综合征（SIRS）常并发于急性脑出血（ICH），并可能影响患者预后。然而，SIRS对急性脑出血患者的预后价值仍存在争议。本荟萃分析旨在评估SIRS在该患者群体中的预后意义。 方法：我们系统检索了PubMed、Embase和Web of Science，以识别探讨SIRS与急性脑出血患者不良结局——即死亡、不良功能结局（PFO）和血肿扩大——之间关联的研究。使用随机效应模型汇总调整后的优势比（OR）及其95%置信区间（CI）。 结果：共纳入9项研究，总计6,976例急性脑出血患者。荟萃分析显示，发生SIRS的急性脑出血患者相较于无SIRS患者，短期死亡风险显著更高（OR 2.43；95% CI 1.48-3.99）。SIRS还与3个月时PFO风险增加（OR 1.47；95% CI 1.15-1.88）和12个月时PFO风险增加（OR 1.76；95% CI 1.16-2.68）相关，而在出院时PFO方面未观察到显著关联（OR 2.41；95% CI 0.69-8.44）。此外，SIRS与血肿扩大风险显著升高相关（OR 2.76；95% CI 1.68-4.54）。 结论：SIRS（系统性炎症反应综合征）的发展与急性ICH（脑出血）患者短期死亡率、PFO和血肿扩大的风险增加相关。然而，由于先前研究的数量有限，这些发现应被视为探索性的。需要大型前瞻性研究来验证这些结果并明确SIRS评估的潜在临床效用。
完整摘要 · 英文原文
OBJECTIVE: Systemic inflammatory response syndrome (SIRS) frequently complicates acute intracerebral hemorrhage (ICH) and may affect patient prognosis. However, the prognostic value of SIRS in patients with acute ICH remains controversial. This meta-analysis aimed to assess the prognostic significance of SIRS in this patient population. METHODS: We systematically searched PubMed, Embase, and Web of Science to identify studies investigating the associations between SIRS and adverse outcomes-namely mortality, poor functional outcome (PFO), and hematoma expansion-in patients with acute ICH. Pooled adjusted odds ratios (OR) with 95% confidence intervals (CI) were synthesized using a random-effects model. RESULTS: Nine studies enrolling a total of 6,976 patients with acute ICH were included. Meta-analyses revealed that patients with acute ICH complicated by SIRS exhibited a substantially higher risk of short-term mortality (OR 2.43; 95% CI 1.48-3.99) relative to patients without SIRS. SIRS was also associated with increased risks of PFO at 3 months (OR 1.47; 95% CI 1.15-1.88) and at 12 months (OR 1.76; 95% CI 1.16-2.68), whereas no significant association was observed for PFO at hospital discharge (OR 2.41; 95% CI 0.69-8.44). Moreover, SIRS was associated with a significantly higher risk of hematoma expansion (OR 2.76; 95% CI 1.68-4.54). CONCLUSIONS: The development of SIRS is associated with increased risks of short-term mortality, PFO, and hematoma expansion in acute ICH patients. However, these findings should be considered exploratory due to the limited number of prior studies. Large prospective investigations are needed to validate these results and clarify the potential clinical utility of SIRS assessment.