中国循证医学杂志

中国循证医学杂志

阻塞性睡眠呼吸暂停低通气综合征与血浆YKL-40 水平相关性的 Meta 分析

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目的系统评价甲壳质酶蛋白(YKL-40)在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中的表达水平及与疾病的相关性。方法计算机检索 PubMed、EMbase、MEDLINE、CNKI、WanFang Data 和 VIP 数据库,同时辅以 Google 学术检索等,搜集血浆 YKL-40 水平与 OSAHS 相关性的病例-对照研究,检索时限均为建库至 2017 年 4 月。由 2 位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 RevMan 5.3 软件进行 Meta 分析。结果最终纳入 5 个研究,OSAHS 患者和对照人群共 755 例。Meta 分析结果显示:与对照组相比,OSAHS 患者的血浆 YKL-40 水平更高[SMD=1.20,95%CI(0.33,2.06),P=0.007];亚组分析结果显示,亚洲人群 OSAHS 患者的血浆 YKL-40 水平较对照组更高[SMD=1.79,95%CI(0.83,2.75),P=0.000 2]。轻-中症与重症组 OSAHS 患者血浆 YKL-40 水平比较结果显示,轻症 OSAHS 患者的血浆 YKL-40 水平更低[SMD=–0.83,95%CI(–1.46,–0.19),P=0.01]。结论现有证据表明,YKL-40 水平与 OSAHS 的发病可能有关。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。

ObjectiveTo systematically review the association between the level of plasma YKL-40 and obstructive sleep apnea hypopnea syndrome (OSAHS).MethodsWe searched PubMed, EMbase, MEDLINE, CNKI, WanFang Data, VIP database and supplemented by Google academic retrieval to collect case-control studies about the association between the level of plasma YKL-40 and OSAHS from inception to April 2017. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. And then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 5 case-control studies were included, involving 755 OSAHS patients and control population. The results of meta-analysis showed that the level of plasma YKL-40 in OSAHS patients was higher than that in control group (SMD=1.20, 95%CI 0.33 to 2.06, P=0.007). The subgroup analysis showed that the level of plasma YKL-40 in OSAHS patients from Asia was significantly higher than that in control group (SMD=1.79, 95%CI 0.83 to 2.75, P=0.000 2). The comparison between different severity of OSAHS showed that the wild-medium group had lower plasma level of YKL-40 than the severe group (SMD=–0.83, 95%CI –1.46 to –0.19, P=0.01).ConclusionYKL-40 may play an important role in the pathogenesis of OSAHS. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusions.

关键词: 阻塞性睡眠呼吸暂停低通气综合征; 甲壳质酶蛋白; 病例-对照研究; Meta 分析

Key words: Obstructive sleep apnea hypopnea syndrome; Chitinase-like protein (YKL-40); Case control study; Meta-analysis

引用本文: 白敏, 杨雪, 童翔, 刘思彤, 王东光, 范红. 阻塞性睡眠呼吸暂停低通气综合征与血浆YKL-40 水平相关性的 Meta 分析. 中国循证医学杂志, 2018, 18(4): 354-358. doi: 10.7507/1672-2531.201710056 复制

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