凝血酶原基因G20210A突变与脑静脉系统血栓发病风险关系的Meta分析

Correlation of the prothrombin gene G20210A mutation and cerebral venous thrombosis risk:a meta-analysis

目的系统评价凝血酶原基因G20210A突变与脑静脉系统血栓发病风险之间的相关性。方法计算机检索PubMed、Springer、Google Scholar、The Cochrane Library(2016年1期)、CNKI、WanFang Data和CBM数据库,搜集凝血酶原基因G20210A突变与脑静脉系统血栓发病风险相关性的研究,检索时限均为从建库至2016年1月。由2位评价员独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5.3和Stata 12.0软件进行Meta分析。结果共纳入26个病例-对照研究,包括1 361例脑静脉系统血栓患者和6 323例对照人群。Meta分析结果显示:凝血酶原基因G20210A突变会显著增加脑静脉系统血栓的发病风险[OR=4.56,95%CI(3.51,5.93),P<0.000 01]。敏感性分析提示研究结果稳定;发表偏倚检测未发现发表偏倚。亚组分析结果提示,凝血酶原基因G20210A突变能显著增加成人脑静脉系统血栓发病风险[OR=5.02,95%CI(3.81,6.60),P<0.000 01],但其与儿童脑静脉系统血栓发病风险无明显相关性[OR=1.99,95%CI(0.83,4.79),P=0.12]。结论凝血酶原基因G20210A突变能显著增加脑静脉系统血栓的发病风险。受纳入研究数量和质量的限制,上述结论尚需开展更多高质量研究予以验证。

Objective To systematically review the association between prothrombin gene G20210A mutation and the risk of cerebral venous thrombosis （CVT）. Methods Databases including PubMed, Springer, Google Scholar, The Cochrane Library （Issue 1, 2016）, CNKI, WanFang Data and CBM were searched for case-control studies concerning the association between prothrombin gene G20210A mutation and cerebral venous thrombosis risk from inception to lanuary 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software and Stata 12.0 software. Results A total of 26 case-control studies were included, involving 1 361 CVT cases and 6 323 controls. The results of meta-analysis showed that： there was a significant association between prothrombin gene G20210A mutation and CVT risk （OR=4.56, 95% CI 3.51 to 5.93, P〈0.000 01）. Sensitivity analysis showed no significant publication bias was detected confirmed the stability of results. Subgroup analysis showed that G20210A mutation increased CVT risk in adults （OR=5.02, 95% CI 3.81 to 6.60, P〈0.000 01）, but not in children （OR=1.99, 95% CI 0.83 to 4.79, P=0.12）. Conclusion Prothrombin gene G20210A mutation can significantly increase the CVT risk. Due to the limited quality and quantity of included studies, the above results are needed to be validated by more high quality studies.