白细胞介素4受体AQ576R基因多态性与支气管哮喘易感性关系的荟萃分析

Meta-analysis on interleukin-4 receptor a chain Q576R gene polymorphisms and bronchial asthma susceptibility

目的 应用荟萃分析方法探讨白细胞介素4受体A（IL-4RA）Q576R基因多态性与支气管哮喘（简称哮喘）易感性的关系.方法 检索Pubmed数据库、Embase数据库、中国知网、万方数据库中IL-4RA Q576R基因多态性与哮喘易感性关系的病例对照研究,采用隐性模型和显性模型合并IL-4RA Q576R基因多态性与哮喘易感性的OR值,并进行过敏性哮喘和非过敏性哮喘的亚组分析、敏感度分析和文献的发表偏倚检验.结果 纳入的16篇文献均满足遗传平衡检验,累计哮喘病例2675例,其中过敏性哮喘1202例,非过敏性哮喘331例.隐性模型经检验未发现明显异质性,采用固定效应模型分析.显性模型经检验发现明显异质性,采用随机效应模型分析.隐性模型RR/（QQ＋QR）计算总体合并OR值为2.02（95%CI为1.53～2.66）,其中过敏性哮喘组合并OR值为2.26（95%CI为1.47～3.49）.显性模型（RR＋QR）/QQ计算总体合并OR值为1.02（95%CI为1.06～1.53）.结论 IL-4RA Q576R基因多态性与哮喘易感性有一定相关性.

Objective To study the association between interleukin-4 receptor α chain （IL-4RA）Q576R polymorphisms and bronchial asthma susceptibility by Meta-analysis. Methods Four medical databases, including Pubmed, Embase, CNKI and Wanfang, were searched for the case-control studies about the IL-4RA polymorphisms and bronchial asthma susceptibility. Odds ratios（OR） of IL-4RA Q576R genotype distributions in asthma patients against healthy controls were analyzed in both RR vs QR ＋ QQ model and QR ＋ RR vs QQ model. Analyses were performed for asthma in general and for subgroups based on the atopy status of the asthma population. The sensitivity analysis and the publication bias tests were conducted. Results Fifteen case-control studies, with 2675 asthma cases, 1202 atopic asthma cases and 331 nonatopic asthma cases respectively, were identified and all control group genotype frequencies were consistent with Hardy-Weinberg equilibrium. In genotype RR vs QR ＋ QQ model no heterogeneity among the studies was found, while in genotype QR ＋ RR vs QQ model, heterogeneity among these studies was found.These studies were analyzed by fixed-effect model （ RR vs QR ＋ QQ model） or random-effect model （ QR ＋RR vs QQ model）. The pooled odds ratio of IL-RA Q576R genotype RR vs QR ＋ QQ was 2. 02 （95% CI：1.53 -2. 66）, and the pooled odds ratio in this model in the atopic asthma subgroup was 2. 26（95% CI：1.47- 3.49）, while the pooled odds ratio （QR ＋ RR vs QQ model） was 1.02 （95% CI： 1.06- 1.53 ）.Conclusion A meta-analysis of results from case-control studies strongly supports the conclusion that IL-4RA Q576R polymorphisms impart a modest yet significant risk for asthma.