慢性阻塞性肺疾病患者血清胰岛素样生长因子-Ⅰ水平研究的Meta分析

Meta-analysis of the level of insulin-like growth factor-Ⅰ in chronic obstructive pulmonary disease

目的 探讨血清胰岛素样生长因子-Ⅰ在慢性阻塞性肺 疾 病 （COPD）中 的临床意义。方法 计算机检索Webofscience、PubMed、Embase、万方、中国学术期刊全文数据库 （CNKI）,查找国内外关于检测 COPD患者血清胰岛素样生长因子-Ⅰ的随机对照研究,检索时限为建库至2017年6月。由2名独立的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Stata10.0和 ReviewManager5.2软件进行 Meta分析。结果最终纳入 10篇 文献,11个研究,其中包括病例组患者629例,健康对照组478例。Meta分析结果显示血清胰岛素样生长因子-Ⅰ水平与 COPD无明显统计学关联性 （SMD=1.31,95%CI ：-0.15～2.77,P 〉0.05）,同时,血清胰岛素样生长因子-Ⅰ水平与慢性阻塞性肺疾病急性加重期也无统计学关联性 （SMD=-0.34,95%CI ：-2.98～2.30,P 〉0.05）,特别是在中国人群中。通过 Begg′s和 Egger′s检验判断发表偏倚,结果未发现任何偏倚 （P 〉0.05）。结论 血清胰岛素样生长因子-Ⅰ水平可能与 COPD患病无明显相关性,但需 扩大样本量继续进行该细胞因子与 COPD关系的研究,进一步确认研究结果。

Objective To investigate the clinical significance of insulin-like growth factor-Ⅰ（IGF- Ⅰ ） level in patients with chronic obstructive pulmonary disease （COPD）. Methods Randomized controlled studies focused on the association between the IGF-Ⅰ level and COPD were searched in databases containing Web of science, PubMed, Embase, WanFang, China National Knowledge Infrastructure from the time of databasesr establishment to June, 2017. Two reviewers independently screened the contents of each article and retrieved data. Review Manager 5.2 and Stata 10.0 software were jointly used to process the meta-analysis. Results Ten articles with eleven case-control studies were included in this meta-analysis. The data included 629 patients with COPD and 478 healthy persons. The result indicated that IGF-Ⅰ level in blood serum was not significantly associated with COPD（SMD = 1.31,95% （71 ：-0.15-2.77, P 〉0.05） and acute exacerbation chronic obstructive pulmonary disease （AECOPD） （ SMD = --0.34, 95 % CI ： - 2.98-2.30, P 〉 0.05 ）, especially in Chinese. Publication bias was assessed by Begg＇s test and Egger＇s test, the results suggested a lack of significant publication bias of the current meta analysis （P 〉 0.05）. Conclusions The IGF-Ⅰ level in blood serum was not significantly associated with COPD and AECOPD. Because of variation and limitation of sample, more well designed studies were needed to warrant a unanimous conclusion.