环氧化酶-2基因-765G/C位点多态性与缺血性脑卒中相关性的Meta分析

Correlation between-765G/C Polymorphism of Cydooxygenase-2 Gene and the Risk of Ischemic Stroke:A Meta-analysis

目的评价环氧化酶-2(cyclooxygenase-2,COX-2)基因-765G/C位点多态性与缺血性脑卒中的相关性。方法计算机检索Pub Med、EMbase、The Cochrane Library(2015年第3期)、CNKI、CBM、VIP和Wan Fang Data数据库,搜集有关COX-2基因-765G/C位点多态性与缺血性脑卒中发病风险相关性的病例对照研究或巢式病例对照研究,检索时限均从建库至2015年3月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.1和Stata 12.0软件进行Meta分析。结果共纳入10个研究,包括2 611例缺血性脑卒中患者和18 589例对照。Meta分析结果显示:COX-2基因-765G/C位点多态性与缺血性脑卒中易感性无相关性[GC+CC vs.GG:OR=1.05,95%CI(0.88,1.25),P=0.620;CC vs.GG+GC:OR=1.04,95%CI(0.83,1.30),P=0.730;GC vs.GG:OR=1.04,95%CI(0.87,1.25),P=0.630;CC vs.GG:OR=1.09,95%CI(0.86,1.36),P=0.480;C vs.G:OR=1.03,95%CI(0.89,1.20),P=0.700]。亚组分析结果显示,COX-2基因-765G/C位点多态性是非洲裔美国人缺血性脑卒中的危险因素[GC+CC vs.GG:OR=1.42,95%CI(1.12,1.78),P=0.003;GC vs.GG:OR=1.39,95%CI(1.09,1.78),P=0.008;CC vs.GG:OR=1.51,95%CI(1.04,2.18),P=0.030;C vs.G:OR=1.27,95%CI(1.08,1.51),P=0.004],而与黄种人及高加索人种缺血性脑卒中无关。结论当前证据显示,COX-2基因765G/C位点多态性可能是非洲裔美国人缺血性脑卒中的遗传危险因素,与黄种人及高加索人种缺血性脑卒中风险无明显相关性。受纳入研究数量和质量的影响,上述结论尚需开展更多高质量研究予以证实。

Objective To explore the correlation between -765G/C polymorphism of cyclooxygenase-2 （COX- 2） gene and the risk of ischemic stroke （IS）. Methods PubMed, CBM, The Cochrane Library （Issue 3, 2015）, CNKI, CBM, VIP and WanFang Data were searched from inception to March 2015 to collect case-control or nested case-control studies about -765G/C polymorphism of COX-2 gene and the risk of IS. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.1 software and Stata 12.0 software. Results A total of 10 studies involving 2 611 cases and 18 589 controls were included. The results of meta-analysis showed that, there was no correlation between -765G/C polymorphism and the risk of IS （GC＋CC vs. GG： OR=1.05, 95%CI 0.88 to 1.25, P=0.620; CC vs. GG＋GC： OR=1.04, 95%CI 0.83 to 1.30, P=0.730; GC vs. GG： OR=1.04, 95%CI 0.87 to 1.25, P=0.630; CC vs. GG： OR=1.09, 95%CI 0.86 to 1.36, P=0.480; C vs. G： OR=1.03, 95%CI 0.89 to 1.20, P=0.700）. Subgroup analysis results showed that, the COX-2 gene -765G/C polymorphism was a risk factor for IS in African-Americans （GC＋CC vs. GG： OR=1.42, 95%CI 1.12 to 1.78, P=0.003; GC vs. GG： OR=1.39, 95%CI 1.09 to 1.78, P=0.008; CC vs. GG： OR=l.51, 95%CI 1.04 to 2.18, P=0.030; C vs. G： OR=1.27, 95%CI 1.08 to 1.51, P=0.004）, but not in Asians and Caucasians. Conclusion Current evidence shows that -765G/C polymorphism of COX-2 gene may be a genetic risk factor for IS in African-Americans, but not in Asians and Caucasians. Due to the limited quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.