中国循证医学杂志

中国循证医学杂志

凝血酶原基因 G20210A 突变与脑静脉系统血栓发病风险关系的 Meta 分析

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目的 系统评价凝血酶原基因 G20210A 突变与脑静脉系统血栓发病风险之间的相关性。 方法 计算机检索 PubMed、Springer、Google Scholar、The Cochrane Library(2016 年 1 期)、CNKI、WanFang Data 和 CBM 数据库,搜集凝血酶原基因 G20210A 突变与脑静脉系统血栓发病风险相关性的研究,检索时限均为从建库至 2016 年 1 月。由 2 位评价员独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用 RevMan 5.3 和 Stata 12.0 软件进行 Meta 分析。 结果 共纳入 26 个病例-对照研究,包括 1 361 例脑静脉系统血栓患者和 6 323 例对照人群。Meta 分析结果显示:凝血酶原基因 G20210A 突变会显著增加脑静脉系统血栓的发病风险[OR=4.56,95% CI(3.51,5.93),P<0.000 01]。敏感性分析提示研究结果稳定;发表偏倚检测未发现发表偏倚。亚组分析结果提示,凝血酶原基因 G20210A 突变能显著增加成人脑静脉系统血栓发病风险[OR=5.02,95% CI(3.81,6.60),P<0.000 01],但其与儿童脑静脉系统血栓发病风险无明显相关性[OR=1.99,95% CI(0.83,4.79),P=0.12]。 结论 凝血酶原基因 G20210A 突变能显著增加脑静脉系统血栓的发病风险。受纳入研究数量和质量的限制,上述结论尚需开展更多高质量研究予以验证。

Objective To systematically review the association between prothrombin gene G20210A mutation and the risk of cerebral venous thrombosis (CVT). Methods Databases including PubMed, Springer, Google Scholar, The Cochrane Library (Issue 1, 2016), CNKI, WanFang Data and CBM were searched for case-control studies concerning the association between prothrombin gene G20210A mutation and cerebral venous thrombosis risk from inception to January 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software and Stata 12.0 software. Results A total of 26 case-control studies were included, involving 1 361 CVT cases and 6 323 controls. The results of meta-analysis showed that: there was a significant association between prothrombin gene G20210A mutation and CVT risk (OR=4.56, 95% CI 3.51 to 5.93,P<0.000 01). Sensitivity analysis showed no significant publication bias was detected confirmed the stability of results. Subgroup analysis showed that G20210A mutation increased CVT risk in adults (OR=5.02, 95% CI 3.81 to 6.60,P<0.000 01), but not in children (OR=1.99, 95% CI 0.83 to 4.79,P=0.12). Conclusion Prothrombin gene G20210A mutation can significantly increase the CVT risk. Due to the limited quality and quantity of included studies, the above results are needed to be validated by more high quality studies.

关键词: 脑静脉系统血栓; 凝血酶原基因; G20210A; 基因突变; 相关性; Meta 分析

Key words: Cerebral venous thrombosis; Prothrombin gene; G20210A; Gene mutation; Correlation; Meta-analysis

引用本文: 封红亮, 刘煜敏, 王美瑶, 张仁伟, 于晴, 娜迪热·艾孜热提艾力, 李艳. 凝血酶原基因 G20210A 突变与脑静脉系统血栓发病风险关系的 Meta 分析. 中国循证医学杂志, 2017, 17(3): 276-282. doi: 10.7507/1672-2531.201602015 复制

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