基线维生素D与慢性丙型肝炎持久病毒学应答相关性的Meta分析

A meta analysis of the correlation between baseline vitamin D level and sustained virological response of chronic hepatitis C

目的探讨基线维生素D水平与HCV基因1、4型感染者对标准抗病毒治疗持久病毒学应答(SVR)的关系。方法检索数据库中有关基线维生素D水平与HCV基因1、4型慢性感染者接受抗病毒治疗后SVR相关性的文献,meta分析比较SVR组和非SVR组的基线维生素D水平。结果共检索到210篇相关文献,其中符合纳入标准5篇,meta分析结果显示,基线维生素D水平在SVR组(32.9 ng/mL)与非SVR组(28.3 ng/mL)的加权均数差(WMD)为6.759(95%CI:1.786,11.733),两组的基线维生素D水平差异有统计学意义(Z=2.66,P=0.008)。结论 HCV基因1、4型慢性感染者接受标准抗HCV治疗获得SVR者的基线维生素D水平高于未获得SVR者。

Objective To investigate the relationship between baseline vitamin D levels and sustained virological response （SVR） on the combination therapy of pegylated interferon plus ribavirin in patients with chronic infection of hepatitis C virus （HCV） genotype 1 or 4 .Methods Relevant studies were selected by systematically searching on PubMed ,Web of Science ,EMBASE ,the Cochrane Library and the Chinese Medical databases （CBM ,WanFang ,CNKI and Vip） .Studies referring to chronic hepatitis C （CHC） with HCV genotypes 1 or 4 ,treatment with pegylated interferon plus ribavirin ,and level of baseline vitamin D were collected .The differences of baseline vitamin D levels between SVR groups and non-SVR groups were compared and evaluated .Results Two hundred and ten references were searched out initially ,while only 5 were in accordance with the inclusion criterions for further analysis .Meta analysis was performed by software Stata 12 with random effect model .The results showed that the weighted mean difference （WMD） of baseline vitamin D level between SVR group （32 .9 ng/mL） and non-SVR group （28 .3 ng/mL） was 6 .759（95% CI：1 .786-11 .733） .The baseline vitamin D in SVR group was significantly higher than that in non-SVR group （Z=2 .66 ,P=0 .008） .Conclusion The baseline vitamin D level is positively correlated with SVR in CHC patients infected with HCV genotype 1 or 4 who undergo pegylated interferon plus ribavirin therapy .