金黄色葡萄球菌超抗原与慢性鼻窦炎伴鼻息肉发病的荟萃分析

The relationship between staphylococcus aureus superantigen and chronic rhinosinusitis with nasal polyps:a meta-analysis

目的慢性鼻窦炎伴鼻息肉是全球健康问题,因其易复发且症状较重,而严重影响患者生存质量。细菌超抗原学说有可能解释其发病机制。本荟萃分析旨在研究金葡菌超抗原与慢性鼻窦炎伴鼻息肉发病的关系。方法计算机检索Pubmed、MEDLINE、EMBASE、中国知网、万方数据库、CBM和VIP中关于金葡菌超抗原与慢性鼻窦炎伴鼻息肉的病例对照研究,时限为从建库到2013年1月。对纳入研究的资料进行严格的质量评价与提取,对符合标准的文献进行荟萃分析。统计学分析应用RevMan 5.0软件和GRADEprofiler 3.2.2软件。结果共纳入12篇病例对照研究。荟萃分析结果显示:病例组与对照组的鼻腔金葡菌培养阳性率[OR=5.16,95%CI(2.44,10.90),P<0.0001]、金葡菌超抗原阳性率[OR=11.79,95%CI(3.69,37.63),P<0.0001]、特异性IgE阳性率[OR=12.67,95%CI(5.08,31.61),P<0.00001]的差异均有统计学意义。病例组中金葡菌超抗原或抗体阳性组与阴性组嗜酸粒细胞计数相比较,其差异没有统计学意义[WMD=36.75,95%CI(-8.09,81.60),P=0.11]。结论金葡菌超抗原与慢性鼻窦炎伴鼻息肉具有相关性,金葡菌超抗原可能是慢性鼻窦炎伴鼻息肉发病的危险因素。

Objective Chronic rhinosinusitis with nasal polyps is a worldwide health problem.Because it tends to relapse and has serious symptoms,it has a bad effect on patients’life quality.Bacteria superantigen hypothesis may explain its pathogenesis.This Meta-analysis aims at studying the relationship between staphylococcus aureus superantigen and chronic rhinosinusitis with nasal polyps.Methods Pubmed,MEDLINE,EMBASE,CNKI,Wanfang Data,CBM and VIP were searched for the case-control study of the relationship between staphylococcus aureus superantigen and chronic rhinosinusitis with nasal polyps from the date of establishment of the databases to January of 2013.The included studies were evaluated strictly.The extracted data were analyzed by Revman 5.0 and GRADEprofiler 3.2.2.Results A total 12 case-control studies were discovered.Meta-analysis showed the comparisons of the case group and the control group about the positive culture rate of staphylococcus aureus in nasal cavity, its superantigen and its specific IgE（OR=5.16,95%CI（2.44,10.90）,P〈0.0001;OR=11.79,95%CI（3.69,37.63）,P〈0.0001;and OR=12.67,95%CI（5.08,31.61）,P〈0.00001,respectively）and the comparison of superantigen or antibody positive group and negative group in the cases about the amount of eosnophils（WMD=36.75,95%CI（-8.09,81.60）,P=0.11）.Conclusion Staphylococcus aureus superantigen may be a risk factor for chronic rhinosinusitis with nasal polyps,the two are relevant.