谷丙、谷草转氨酶与丙种球蛋白无反应型川崎病相关性的Meta分析

Alanine aminotransferase and aspartate aminotransferase levels and intravenous immunoglobulin- resistance in children with Kawasaki disease: a systematic review

目的通过Meta分析探讨ALT、AST与静脉注射丙种球蛋白针（简称丙球）无反应型川崎病的相关性。方法检索Pubmed等6个中英文数据库关于ALT、AST与丙球无反应型川崎病相关性的研究报道,检索时间为2002至2016年,对符合要求的文献提取数据,对于可以合并统计量的研究采用Review Manager软件（Revman 5.2）进行Meta分析,对于无法进行Meta分析的研究进行定性综合。结果共计25个研究纳入最终的系统评价,其中20个研究可以合并统计量,另外5个研究不能合并统计量,进行定性系统评价。在进行Meta分析的20个研究中,ALT共纳入19个研究用于Meta分析,AST共纳入16个研究用于Meta分析;Meta分析结果显示,与丙球敏感的患儿比较,丙球无反应的患儿血中ALT（overall SMD=0.63,95%CI：0.44-0.82,P〈0.01）、AST（ove ra ll SMD=0.57,95%CI：0.49-0.65,P〈0.01）水平更高。结论与丙球敏感的患儿相比,丙球无反应的患儿血清中ALT、AST水平更高。

Objective To investigate the correlation between alanine aminotransferase（ALT） and aspartate aminotransferas（AST） and intravenous immunoglobulin（IVIG）-resistance in children with Kawasaki disease by a systematic review.Methods PubMed,the Cochrane Library,EMBASE,Wanfang database,VIP,CNKI database from January 2002 to January 2016 were searched for study reports about the correlation between ALT,AST and IVIG-resistance in Kawasaki disease,the data of studies meeting the requirements were extracted and quantitatively synthesized.Results A total of 25 studies were included in the final systematic review,among which statistics were able to be merged in 20 studies;qualitative analysis was performed in other 5 studies.Among 20 studies,19 were included in ALT analysis and 15 were included in AST analysis.The results showed that ALT（overall SMD=0.63,95%CI0.44-0.82,P〈0.01） and AST（overall SMD=0.57,95%CI0.49-0.65,P〈0.01）are associated with the occurrence of IVIG-resistance in Kawasaki disease.Conclusion The serum levels of ALT and AST are higher in children with IVIG-resistant Kawasaki disease than those in the children with IVIG-sensitive Kawasaki disease.