抗磷脂抗体与原发性胆汁性肝硬化相关性的荟萃分析

The relationship between antiphospholipid antibodies and primary biliary cirrhosis:a Meta-analysis

目的评价抗磷脂抗体(antiphospholipid antibodies,APL)和原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)的相关性。方法计算机检索Pub Med、Medline Embase、CNKI及万方数据库,获取APL与PBC关联性的研究,APL包括抗心磷脂抗体(anticardiolipin antibodies,ACL)、抗β2GPⅠ抗体(anti-beta 2-glycoproteinⅠantibody,anti-β2GPⅠ)和狼疮抗凝物(lupus anticoagulant,LA)。结果共纳入PBC与ACL、抗β2GPⅠ抗体关联的文献6篇,没有发现LA阳性的文章,累计PBC患者380例,健康对照组495名,自身免疫性肝炎(antoimmune hepatitis,AIH)165例,原发性硬化性胆管炎(primary sclerosing cholangitis,PSC)78例。Meta分析结果表明,PBC患者ACL和抗β2GPⅠ抗体阳性率均明显高于健康对照组(OR=12.06,95%CI:3.61~40.26;OR=38.46,95%CI:16.16~91.55)。PBC患者ACL和抗β2GPⅠ抗体阳性率均低于AIH患者(OR=0.43,95%CI:0.26~0.71;OR=0.48,95%CI:0.32~0.73),与PSC相比,两种抗体阳性率差异无统计学意义(OR=1.91,95%CI:0.98~3.71;OR=1.27,95%CI:0.55~2.97)。结论 PBC与ACL和抗β2GPⅠ抗体存在显著关联,它在PBC发展进程中所起的作用有待进一步研究。

Objective To assess the relationship between antiphospholipid antibodies （APL） and primary biliary cirrhosis （PBC）. Methods Studies evaluating the relationship between PBC and APL [ including anticardiolipin anti- bodies （ACL） , anti-beta 2-glycoprotein I antibody （anti-β2GP I ） , lupus anticoagulant （LA） antibodies]were system- atically searched in the PubMed, Medline Embase, CNKI and Wanfang Database. Results A total of 6 studies [ （380 patients with PBC, 495 healthy controls, 165 patients with autoimmune hepatitis （AIH） and 78 patients with primary sclerosing cholangitis （PSC） ] were included in the study on the prevalence of APL and showed that PBC were signifi- cantly associated with the presence of ACL and anti-β2GP ] , ACL and anti-β2GP ] were found more frequently in PBC compared with health controls （OR=12.06, 95% CI： 3.61-40.26; 0R=38.46, 95 % CI： 16.16-91.55）; ACL and anti-132GP I prevalence were lower in PBC compared with AIH （OR =0.43, 95% CI： 0. 26 -0.71 ; OR =0.48, 95% CI： 0. 32-0.73）; there was no significance between PBC and PSC （OR = 1.91, 95% CI： 0. 98 -3.71; OR = 1.27, 95% CI： 0. 55 -2.97）. Conclusion PBC is significantly associated with ACL and anti-β2GP I positivity, the clinical relevence should be further studied.