川崎病与病原微生物关系的meta分析

The association between Kawasaki disease and pathogens: a meta-analysis

目的系统评价与川崎病发病可能相关的病原。方法全面检索CNKI、PubMed、EMbase、Medline数据库中1979年1月至2010年10月的川崎病病因中病原检测的相关文献，语种限中文和英文。纳入原始研究、质量评价并提取资料，剔除不符合研究标准的文献，对所纳入的研究数据采用RevMan5软件进行统计学分析。结果纳入12篇文献，共研究5种病原菌，包括593例川崎病患儿和1152例对照组儿童。Meta分析结果显示，金黄色葡萄球菌和A组链球菌，其合并OR值为4．26（95％CI：2．54～7．16，P〈0．05）。人类微小病毒B19，其合并OR值为6．58（95％CI：2．37～18．25，P〈0．05）。支原体和衣原体，其合并OR值为3．41（95％CI：1．99～5．84，P〈0．05）。人类冠状病毒NL-63，其合并OR值为0．75（95％CI：0．20～2．78，P〉0．05）。结论病原体感染参与川崎病发病，相关病原有金黄色葡萄球菌、A组链球菌，支原体和衣原体，人类微小病毒B19，而人类冠状病毒NL-63与川崎病发生无相关性。上述结果尚需进一步证实。

Objection To systematically evaluate the pathogens related to Kawasaki disease （KD）. Methods The relevant articles written in English and Chinese about the etiology of Kawasaki disease from Jan. 1979 to Oct 2010 in CNKI, PubMed, Embase and Medline databases were comprehensively searched. The quality evaluation and information extraction were performed on the included original articles, and then the articles that did not meet the study standards were removed. Finally all the data included were analysed by RevMan 5.0 software. Results Twelve articles that looked at 5 types of pathogens were included with 593 cases of KD children and 1 154 control children. The results of meta analysis were as follows： the odds ratio （OR） of staphylococcus aureus and group A streptococcus was 4.26 （95%CI, 2.54-7.16, P〈0.05）; OR of human parvovirus B19 was 6.58 （95%CI, 2.37-18.25, P〈0.05）; OR of mycoplasma and chlamydia was 3.41 （95%CI, 1.99- 5.84, P〈0.05）; OR of human coronavirus NL-63 was 0.75 （95%CI, 0.20-2~78, P〉0.05）. Conclusions It is suggested that the pathogens related to the development of KD included staphylococcus aureus, group A streptococcus, human parvovirus B19, mycoplasma and ehlamydia. Meanwhile, human coronavirus NL-63 had no relationship with KD. However, the above results need to be further confirmed.