摘要
目的系统评价高同型半胱氨酸(homocysteine,Hcy)血症与对比剂肾病(contrast-induced nephropathy,CIN)的相关性。方法计算机检索CNKI、VIP、WanFang Data、PubMed、The Cochrane Library和Web of Science数据库,搜集有关高Hcy血症与CIN关系的病例-对照研究,检索时限均为建库至2017年11月30日。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 12.0软件进行Meta分析。结果共纳入10个病例-对照研究,包括6 124例患者。Meta分析结果显示:调整混杂因素后,高Hcy血症患者在冠脉造影后发生CIN的风险明显增加[OR=1.59,95%CI(1.33,1.89),P<0.001];发生CIN的患者应用对比剂前的血Hcy水平较未发生CIN的患者绝对值更高[WMD=8.74,95%CI(6.18,11.31),P<0.001]。结论现有证据显示高血Hcy水平是CIN的危险因素。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。
Objectives To evaluate the association between high homocysteine（Hcy） levels and risk of contrastinduced nephropathy（CIN）. Methods CNKI, VIP, WanFang Data, PubMed, The Cochrane Library and Web of Science databases were electronically searched to collect the case-control studies on the association between Hcy and risk of CIN from inception to November 30^th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using Stata 12.0 software. Results Ten case-control studies involving 6 124 subjects were included. Meta-analysis showed that the high Hcy level was associated with an increased risk of CIN（OR=1.59, 95%CI 1.33 to 1.89, P〈0.001）, and the homocysteine level in CIN group was higher than that in non-CIN group（WMD=8.74, 95%CI 6.18 to 11.31, P〈0.001）. Conclusions According to the current evidence, the high Hcy level is a risk factor for CIN. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.
作者
薛玉
李静波
王莉娜
XUE Yu;LI Jingbo;WANG Lina(Medical School,Southeast University,Nanjing,210009,P.R.China;School of Public Health,Southeast University,Nanjing,210009,P.R.China)
出处
《中国循证医学杂志》
CSCD
北大核心
2018年第7期700-706,共7页
Chinese Journal of Evidence-based Medicine
基金
国家自然科学基金项目(编号:81673259)
江苏省自然科学基金项目(编号:BK20161435)
