IFN-γ与银屑病相关性的Meta分析

Meta-analysis of the Relationship between IFN-γand Psoriasis

目的评价细胞因子IFN-γ与银屑病的相关性。方法计算机检索Cochrane图书馆2005年第3期、MEDLINE(1996～2005)、CBMdisc(1978～2005),纳入所有研究IFN-γ与银屑病相关性的队列研究、配对与非配对的病例对照研究。由3名评价者共同评价纳入研究质量。采用RevMan4.2.8软件进行Meta分析。结果共纳入23个研究,包括银屑病患者612例,正常对照441例。所有研究均未描述具体的随机抽样方法及其使用的检测方法的特异度。银屑病组血清(或血浆)中的IFN-γ浓度明显高于对照组[SMD合并=0.89,95%CI(0.29,1.48);RR合并=6.20,95%CI(1.78,21.61)];细胞培养上清中IFN-γ浓度稍高于对照组[SMD合并=0.99,95%CI(-0.01,1.99);RR合并=5.54,95%CI(2.03,15.13)]。结论现有研究结果显示,银屑病与IFN-γ升高有关,但由于纳入研究存在选择性偏倚、混杂性偏倚和测量性偏倚的中、高度可能性,影响了研究结果的可靠性,期待将来高质量的研究提供高质量的证据。

Objective To assess the relationship between IFN-γ and psoriasis. Methods We searched The Cochrane Library （Issue 3, 2005）, MEDLINE （1996 to 2005） and the China Biological Medicine Database （1978 to 2005）. The search was conducted in November 2005. The quality of included dinical controlled trials, case studies and cohort studies was evaluated independently by three reviewers. RevMan 4.2.8 software was used. Results In total, 23 studies were included, involving 612 psoriasis patients and 441 healthy controls. All studies did not provide sufficient detail, on the random sampling and the specificity of the kits used for the analyses. Compared with the controls, the serum or plasma IFN-γ inpsoriasis patients showed significantly higher levels （SMD=0.89, 95%CI 0.29 to 1.48; and RR=6.20, 95%CI 1.78 to 21.61）. The concentration of IFN-γ in supernatant obtained from cultured cells showed slightly higher levels （SMD=0.99, 95%CI -0.01 to 1.99; and RR=5.54, 95%CI 2.03 to 15.13）. Conclusion The evidence currently available shows that the increase of IFN-γ may be relevant to psoriasis. However, these results could be affected by the highrisk of selection, confounding and detection bias of included studies. More persuasive evidence, from high quality studies, is needed.