摘要
目的采用Meta分析探讨抗EB病毒(EBV)抗体与中国人群传染性单核细胞增多症(IM)的关系。方法检索中国期刊全文数据库(CNKI)、万方科技期刊全文数据库、Pubmed、EMbase、中国生物医学文献检索数据库(CBM)和维普中文科技期刊全文数据库(VIP)中对IM患者和对照者血清抗EBV抗体进行检测的病例-对照研究,检索时限均为从建库至2018年2月。严格根据纳入和排除标准筛选文献,采用修改后的纽卡斯尔-渥太华量表(NOS)进行质量评价。采用Rev Man 5.3软件计算每种抗EBV抗体血清阳性率的比值比(OR),并对不同文献中各个抗体的OR值进行合并分析,采用敏感性分析来判断结果的稳定性,采用Egger检验评估纳入的研究是否存在发表偏移。结果共纳入16项研究,含1305例IM患者和973例对照者。IM患者抗EB病毒衣壳抗原(EBV-VCA)IgM/IgG/IgA抗体、抗EB病毒早期抗原(EBEA)IgM/IgG抗体血清阳性率明显高于对照者,抗EBV-VCA IgM抗体总体OR=81.67,95%可信区间(CI)为57.88~115.22;抗EBV-VCA IgG抗体总体OR=7.86,95%CI为2.05~30.25;抗EBV-VCA IgA抗体总体OR=15.45,95%CI为1.13~211.81;抗EBEA IgM抗体总体OR=17.21,95%CI为7.76~38.15;抗EBEA IgG抗体总体OR=4.21,95%CI为1.08~16.40。IM患者血清抗EB病毒核心抗原(EBV-NA)IgG抗体阳性率与对照者比较,差异无统计学意义(OR=0.50,95%CI为0.08~3.00,P=0.45)。检测抗EBV-VCA IgG抗体的研究共纳入11项,各研究之间质量差别较大,异质性较大。亚组分析结果显示,各亚组之间差异均无统计学意义(P>0.05)。Egger检验结果显示无发表偏移。结论中国人群IM患者血清抗EBV-VCA抗体和抗EBEA抗体阳性率均明显高于对照者,而血清抗EBV-NA抗体阳性率则低于对照者。
Objective To investigate the relation of anti-Epstein-Barr virus(EBV)antibodies with Chinese population with infectious mononucleosis(IM)by Meta analysis.Methods The databases,including China National Knowledge Infrastructure(CNKI),WANFANG Database,Pubmed,EMbase,Chinese Biological Medicine Database(CBM)and Chinese Weipu Database(VIP),were searched from inception to February 2018.The case-control studies of IM patients and control subjects for anti-EBV antibodies were collected for conducting a Meta analysis.The literatures were strictly screened according to the inclusion and exclusion criteria.Quality assessment was performed using a modified version of the Newcastle-Ottawa scale(NOS).The odds ratios(OR)of seropositivity to anti-EBV antibodies were calculated using Rev Man 5.3.OR for each anti-EBV antibody was combined in a Meta analysis,and the stability was evaluated by sensitivity analysis.Egger test was used to evaluate the publication bias.Results Totally,16 studies were included,including 1305 IM cases and 973 control cases.There was a higher seroprevalence of anti-EBV viral capsid antigen(EBV-VCA)IgM/IgG/IgA antibodies and anti-EBV early antigen(EBEA)IgM/IgG antibodies in IM cases compared to control cases.An overall OR for anti-EBVVCA IgM was 81.67[95%confidence interval(CI)57.88-115.22],that for anti-EBV-VCA IgG was 7.86(95%CI 2.05-30.25),that for anti-EBV-VCA IgA was 15.45(95%CI 1.13-211.81),that for anti-EBEA IgM was 17.21(95%CI 7.76-38.15),and that for anti-EBEA IgG was 4.21(95%CI 1.08-16.40)in IM cases.The difference in seropositivity rates between IM cases and control cases for anti-EBV nuclear antigen(EBV-NA)IgG had no statistical significance(OR=0.50,95%CI 0.08-3.00,P=0.45).A total of 11 studies determined anti-EBV-VCA IgG were various widely in their qualities,and there was considerable heterogeneity in the results of Meta analysis.Subgroup analysis failed to demonstrate a statistical significance in any of the subgroups considered(P>0.05).Egger test showed that there was no publication bias.Conclusions There is a higher seroprevalence of anti-EBV-VCA and anti-EBEA antibodies but not anti-EBV-NA antibody in Chinese population with IM compared to control subjects.
作者
张敏杰
高玉芳
杨飞飞
徐晓莉
ZHANG Minjie;GAO Yufang;YANG Feifei;XU Xiaoli(Department of Clinical Laboratory,Xianyang Central Hospital,Xianyang 712000,Shaanxi,China)
出处
《检验医学》
CAS
2020年第3期214-223,共10页
Laboratory Medicine
