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首页|中国脑卒中后疲劳患病率及发展趋势的 Meta 分析
10.12114/j.issn.1007-9572.2023.0414
来源：中国科学院科技论文预发布平台_logo中国科学院科技论文预发布平台

中国脑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

郝明青 余洁 方茜 薛超 李娟

背景　脑卒中后疲劳（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，以期为我国相关部门制定有针对性地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）、维普中文科技期刊数据库（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后，采用 Stata 16.0 软件进行 Meta 分析。本研究已在 PROSPERO 平台注册：CRD42023427915。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 人，其中 PSF 者 5 764 人。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 以 下 为 40.0%（95%CI=32.3%~48.0%），60~75 岁 为67.9%（95%CI=54.2%~80.1%），75 岁 及 以 上 为 71.9%（95%CI=48.9%~90.5%）； 按 地 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 时 间 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 文 化 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相关趋势无统计学意义（χ2趋势=0.333，P=0.564）；从空间分布来看，全国七个地区之间 PSF 患病率（40.0%~59.3%）差异明显（χ2=122.615，P<0.0001），各省份之间 PSF 患病率（23.3%~74.2%）亦差异明显（χ2=504.294，P<0.0001）；从发表时间来看，2013 年—2023 年我国 PSF 患病率在（32.4%~53.9%）波动变化（χ2趋势 =48.011，r=0.061，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（59.3%）和贵州省（74.2%）最高，而华北地区（40.0%）、华南地区（40.0%）及天津市（23.4%）最低。此外，女性、高龄、无配偶、受教育程度低、无业或退休、脑卒中恢复期、出血性脑卒中等群体 PSF 患病率偏高。受纳入研究数量和质量的限制，上述结论尚需更多高质量研究予以验证。

神经病学、精神病学医学研究方法医学现状、医学发展

中国脑卒中疲劳患病率发展趋势Meta 分析系统评价

郝明青,余洁,方茜,薛超,李娟.中国脑卒中后疲劳患病率及发展趋势的 Meta 分析[EB/OL].(2023-09-12)[2025-11-04].https://chinaxiv.org/abs/202309.00120.点此复制

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. Thereforeunderstanding 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 Chinain order to provide a reference basis for the relevant departments to formulate targeted stroke prevention and treatment strategies. Methods PubMedWeb of ScienceEMbaseCNKIWanfang DataVIPand 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 literatureextracted information and evaluated the risk of bias of the included studies. This study was registered on the PROSPERO platformCRD42023427915. Results A total of 57 cross-sectional studies involving 19 provinces/autonomous regions/municipalities directly under the central government and special administrative regions of Chinawith a total sample size of 13621 individualsincluding 5764 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 groupingthe prevalence was 40.0%95%CI=32.3%-48.0% for those under 60 years of age67.9%95%CI=54.2%-80.0% for those aged 60-75 years by age grouping and 71.9% 95%CI48.9%-90.5% for those aged 75 years and abovethe prevalence was 40.0%95%CI=35.0%-45.2% in North China41.0%95%CI=29.5%-53.0% in Northeast China49.5%95%CI=43.5%-55.8% in East China40.3% 95%CI34.9%-45.8% in Central China40.0%95%CI=28.4%-52.2% in South China59.3%95%CI=54.0%-65.0% in Southwest Chinaand 46.2%95%CI=38.3%-54.0% in Northwest China by regional groupingthe 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 groupingthe 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 groupingthe prevalence was 56.0%95%CI=43.7%-67.9% for elementary school and below46.7%95%CI=39.6%-53.8% for junior high school46.8%95%CI=40.3%-53.4% for senior high schooland 43.6%95%CI=35.7%-51.6% for college and above by education level groupingthe 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 statusthe prevalence was 45.0%95%CI=33.2%-57.8% for those who were employed and 53.8%95%CI=40.1%-67.2% for those who were unemployed or retired by work status groupingthe prevalence was 41.8%95%CI=38.3%-45.3% for those who applied the Fatigue Severity ScaleFSS65.8%95%CI=57.1%-74.0% for those who applied the Check List Individual StrengthCIS50.5%95%CI=44.6%-56.5% for those who applied the Chinese version of the Neurological Fatigue Index for StrokeNFI-stroke52.7%95%CI=43.1%-62.1% for those who applied the Chinese version of the Fatigue Assessment ScaleC-FASand 48.9%95%CI=43.6%-54.2% for those who applied the Mental Fatigue SelfRating ScaleMFS. Additionallyin terms of age distributionthe prevalence of PSF in China increased gradually with ageχ2 trend=87.081r=0.209P<0.01in terms of cultural backgroundthe trend of correlation between the prevalence of PSF in China and education level was not statistically significant χ2 trend=0.333P=0.564and in terms of spatial distributionthe prevalence of PSF40.0%-59.3% varied significantly among the seven regions of the countryχ2=122.615P<0.01and the prevalence of PSF 23.3%-74.2% also varied significantly among provincesχ2=504.294P<0.01from the perspective of the publication timethe prevalence of PSF in China fluctuated in 32.4% to 53.9% from 2013 to 2023χ2 trend=48.011r=0.061P<0.01. Conclusion The results of this study have shown a high overall prevalence of PSF in Chinawith significant differences among regions and provinces. The highest prevalence was found in Southwest China59.3% and Guizhou Province74.2%whereas the lowest prevalence was observed in North China40.0%South China40.0%and Tianjin City23.4%. AdditionallyPSF was found to be more prevalent among certain groupsincluding femalesadvanced ageno spouselow education levelunemployed or retired work statusrecovery phase of strokeand hemorrhagic stroke.Due to the limitation of the number and quality of included studiesmore high-quality studies are needed to verify the above findings.
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