慢性心力衰竭患者血清促炎细胞因子水平变化的系统评价

Changes of Serum Pro- inflammatory Cytokines Concentrations in Chronic Heart Failure Patients:A Systematic Review

目的系统地评价慢性心力衰竭(CHF)患者血清促炎细胞因子水平变化情况。方法计算机检索PubMed、EMBase、Cochrane图书馆、万方数字化期刊数据库以及中国知网(CNKI)中关于血清促炎细胞因子〔白介素6(IL-6)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)〕水平与CHF关系的研究,由2名研究员独立筛选和阅读文献,提取相关资料。采用RevMan 5.1软件行数据分析,标准化均数差(SMD)及其95%置信区间(CI)合并效应量。结果最终共纳入24篇符合标准的文献,Meta分析结果显示,CHF组血清TNF-α〔SMD=2.45,95%CI(1.57,3.33),P<0.0001〕、IL-6〔SMD=2.30,95%CI(1.50,3.11),P<0.0001〕、CRP〔SMD=1.43,95%CI(0.69,2.18),P=0.0002〕水平均高于对照组。结论 CHF患者血清促炎细胞因子TNF-α、IL-6、CRP水平明显升高,炎症与CHF的发生、发展及临床转归密切相关。

Objective To evaluate systematically the changes of serum pro- inflammatory cytokines concentrations in chronic heart failure（ CHF） patients.Methods We searched PubMed,EMBase,Cochrane,Wangfang data and CNKI for studies on relationship of pro- inflammatory cytokines levels 〔interleukin- 6（ IL- 6）,tumor necrosis factor- α（ TNF- α）,C reactive protein（ CRP） 〕 to CHF.Two researchers screened,read literatures and extracted relevant information.RevMan 5.1software was used to do data analysis,standardized mean difference（ SMD） and its 95% confidence intervals（ CI） combined with effect size.Results A total of 24 literatures meeting the standards were enrolled in this study.Meta- analysis showed that the levels of serum TNF- α 〔SMD = 2.45,95% CI（ 1.57,3.33）,P 0.0001〕,IL- 6 〔SMD = 2.30,95% CI（ 1.50,3.11）,P 0.0001〕,CRP 〔SMD = 1.43,95% CI（ 0.69,2.18）,P = 0.0002〕 were higher in CHF group than in control group.Conclusion In CHF patients,levels of TNF- α,IL- 6,CRP increases significantly.Inflammation is closely related to the occurrence,development and clinical outcome of CHF.