血清高迁移率族蛋白B-1水平与结核病关系的Meta分析

Association between serum high mobility group box 1 protein levels and tuberculosis:a Meta-analysis

目的探讨血清高迁移率族蛋白B-1(high mobility group box-1 protein,HMGB1)在结核病中的临床意义。方法计算机检索Web of science、Pub Med、Embase、万方、中国学术期刊全文数据库(CNKI),查找国内外关于检测结核病患者血清高迁移率族蛋白B-1的病例对照研究,检索时限为建库至2017年10月。由2名独立评价者根据纳入及排除标准筛查文献,提取相关数据后,运用Stata 10.0和Review Manager 5.2软件进行meta分析。结果最终纳入9篇文献,10个研究,其中包括病例组患者576例,健康对照组369例。Meta分析结果显示结核病人群血清高迁移率族蛋白B-1浓度较正常人明显升高(SMD=2.27,95%CI:1.43~3.11,P<0.05),高HMGB1浓度可能是结核病的危险因素;根据人群的不同进行亚组分析发现,中国人群中,结核病患者血清高迁移率族蛋白B-1较健康对照组明显升高(SMD=2.34,95%CI:1.42~3.25,P<0.05);根据疾病的种类不同进行亚组分析发现,肺结核患者血清高迁移率族蛋白B-1也较健康对照组明显升高(SMD=1.96,95%CI:1.24~2.67,P<0.05)。通过Begg’s检验判断发表偏倚,结果显示发表性偏倚影响较小(P>0.05)。结论在中国人群中,血清高迁移率族蛋白B-1水平可能与肺结核具有相关性,肺结核患者的血清高迁移率族蛋白B-1水平较高,但因样本量相对较小,需扩大样本量继续进行血清高迁移率族蛋白B-1与结核病关系的研究,进一步确认研究结果。

Objective To investigate the clinical significance of serum high mobility group box 1 protein（HMGB1）levels in the patients with tuberculosis（TB）. Methods Case-control studies concerning the association between serumHMGB1 level and tuberculosis were searched in the databases, including Web of science, PubMed, Wan Fang, and CNKI fromthe time of the establishment of the databases to October, 2017. Two reviewers independently skimmed the contents of eacharticle and retrieved the data. Review Manager 5.2 and Stata 10.0 software were used to assess the Meta-analysis. Results Intotal, ten case-control studies of nine articles were included in this Meta-analysis. The data included 576 TB patients and 369 healthy persons. The total result indicated that the HMGB1 level in blood serum was significantly higher in TB patientscompared with that in the normal healthy persons（SMD=2.27, 95% CI： 1.43-3.11, P〈0.05）. In the subgroup analysis byethnicity, the serum HMGB1 level of TB cases was higher than that of the controls in the studies conducted in China（SMD=2.34, 95%CI： 1.42-3.25, P〈0.05）. In the subgroup analysis by diversity of disease types, the result also showed that theHMGB1 level in blood serum was higher in pulmonary TB patients compared with that in the normal healthy persons（SMD=1.96, 95% CI： 1.24-2.67, P〈0.05）. Conclusion The HMGB1 level in blood serum is significantly associated with TB,especially in Chinese pulmonary TB patients. Because of the limitation of samples, large number of such original studies is stillneeded in the future to reassess this result.