幕上蛛网膜囊肿对认知功能影响的Meta分析

Influence of supratentorial arachnoid cyst on cognitive function: A meta-analysis

摘要:

目的 通过对幕上蛛网膜囊肿患者的认知功能进行Meta分析，为蛛网膜囊肿临床治疗提供参考。方法 以蛛网膜囊肿、认知功能及行为功能为关键词，检索PubMed、Web of Science、Cochrane Library、Embase、万方、CBM、维普及知网，检索时间为建库至2023年8月20日。利用Stata 14.0对数据进行分析，主要指标包括操作智商、言语智商、总智商、色词干扰测验、言语流畅性测验、汉诺塔测验、波士顿命名测验，次要指标包括影像结果及临床症状。结果 最终纳入12篇研究，336个手术病例，83个对照组。Meta分析结果显示，蛛网膜囊肿患者的色词干扰测验、言语流畅性测验及汉诺塔测验与正常对照组之间比较，存在统计学差异（P<0.05），蛛网膜囊肿患者操作智商、言语智商、总智商、色词干扰测验、言语流畅性测验、汉诺塔测验在手术前后的自身对照中有统计学差异（P<0.05），而处理速度指数、工作记忆指数、波士顿命名测验在手术前后无明显差异。蛛网膜囊肿患者临床症状、囊肿体积在手术前后有明显的差异（P<0.05）。结论 部分蛛网膜囊肿患者认知功能评估存在异常，应根据临床症状、影像学检查及神经心理学评估结果进行个体化治疗。

Abstract:

Objective To perform a meta-analysis of cognitive function in patients with supratentorial arachnoid cyst， and to provide a reference for clinical treatment.Methods With arachnoid cyst， cognitive function， and behaviour function as keywords， PubMed， Web of Science， the Cochrane Library， Embase， Wanfang Data， CBM， VIP， and CNKI were searched for related articles published up to August 20， 2023. Stata 14.0 was used for data analysis； primary indicators included performance intelligence quotient （IQ）， verbal IQ， full-scale IQ， color-word interference test， verbal fluency test， Tower of Hanoi， and Boston Naming Test， and secondary indicators included radiological findings and clinical symptoms.Results A total of 12 studies were included， with 336 surgical cases and 83 control cases. The meta-analysis showed that there were significant differences in the scores of color-word interference test， speech fluency test， and Tower of Hanoi between the patients with arachnoid cysts and the normal control group （P <0.05）. The patients with arachnoid cysts had significant changes in performance IQ， verbal IQ， ful-scale IQ， and the scores of color-word interference test， verbal fluency test， and Tower of Hanoi after surgery （P <0.05）， while there were no significant changes in processing speed index， working memory index， and Boston Naming Test after surgery. There were significant changes in clinical symptoms and cyst volume after surgery in patients with arachnoid cysts （P <0.05）.Conclusions Some patients with arachnoid cysts have abnormal cognitive function， and individualized treatment should be performed according to clinical symptoms， radiological examinations， and neuropsychological assessment.