■微血管衰竭可能导致脑络塌陷。然而,关于脑白质疏松症(LA)在侧支募集中的作用仍存在争议.我们,因此,对LA与脑络的相关性进行了系统评价和荟萃分析.
■OvidMedline,PubMed,Embase,WebofScience,从成立到2021年8月,搜索了三个中国数据库。两种脑络,包括威利斯环(CoW)和软脑膜络脉(LC),被单独调查。随机效应模型用于计算合并比值比(OR)。进行Meta回归和亚组分析以探索异质性的潜在来源。
■从符合我们纳入标准的14项研究(n=2,451)中,13名患者的数据可以汇总用于分析.总的来说,重度LA和不完全CoW之间存在显著关联(合并OR1.66,95%CI1.18-2.32,p=0.003),异质性低(I2=5.9%)。这种关联在深LA中仍然显著(合并OR1.48,95%CI1.04-2.11,p=0.029,I2=0),但不是室周LA.同样,LA和LC之间存在显着关联(合并OR1.73,95%CI1.03-2.90,p=0.037),但具有高度异质性(I2=67.2%)。Meta回归表明样本量与效应大小呈负相关(p=0.029)。此外,大部分研究(7/9)纳入重度LA与低LC患者大血管闭塞卒中的关系分析,当汇集七项研究时,这种关系仍然很重要,但具有高度异质性。
■重度LA与不良络脉的患病率较高相关。这种关联对于CoW是稳健的,但是对于LC是弱的。需要进一步的研究来探索潜在的机制。
UNASSIGNED: Microvascular failure might result in the collapse of cerebral collaterals. However, controversy remains regarding the role of leukoaraiosis (LA) in collateral recruitment. We, therefore, performed a systematic
review and meta-analysis of the association between LA and cerebral collaterals.
UNASSIGNED: Ovid Medline, PubMed, Embase, Web of Science, and three Chinese databases were searched from inception to August 2021. Two types of cerebral collaterals, including Circle of Willis (CoW) and leptomeningeal collaterals (LC), were investigated separately. Random effect models were used to calculate the pooled odds ratio (OR). Meta-regression and subgroup analyses were performed to explore the potential sources of heterogeneity.
UNASSIGNED: From 14 studies (n = 2,451) that fulfilled our inclusion criteria, data from 13 could be pooled for analysis. Overall, there was a significant association between severe LA and incomplete CoW (pooled OR 1.66, 95% CI 1.18-2.32, p = 0.003), with low heterogeneity (I 2 = 5.9%). This association remained significant in deep LA (pooled OR 1.48, 95% CI 1.04-2.11, p = 0.029, I 2 = 0), but not periventricular LA. Similarly, there was a significant association between LA and LC (pooled OR 1.73, 95% CI 1.03-2.90, p = 0.037), but with high heterogeneity (I 2 = 67.2%). Meta-regression indicated a negative association of sample size with the effect sizes (p = 0.029). In addition, most of the studies (7/9) included into the analysis of the relationship of severe LA with poor LC enrolled subjects with large vessel occlusion stroke, and this relationship remained significant when pooling the seven studies, but with high heterogeneity.
UNASSIGNED: Severe LA is associated with a higher prevalence of poor collaterals. This association is robust for CoW but weak for LC. Further studies are required to explore the underlying mechanisms.