血清肿瘤坏死因子α和肠道病毒71型感染手足口病相关性的meta分析

Meta analysis of relationship between serum tumor necrosis factor α and hand,foot and mouth disease infected with EV71

目的探讨血清肿瘤坏死因子α(TNF-α)与肠道病毒71型感染手足口病的关系,为临床诊断提供理论依据。方法采用计算机检索Pub Med、Web of Science、Cochrane Library、中国知网(CNKI)、万方(Wanfang)、维普数据库(VIP),收集2006年1—5月国内外已发表的有关EV71感染手足口病和血清TNF-α水平的患者对照研究文献。采用Stata 14.0软件进行meta分析,估计综合效应标准化均数差(SMD)及其95%CI可信区间。结果共纳入9篇文献,EV71手足口病患者685例,对照组252例,Meta分析的结果显示,EV71手足口病患者血清TNF-α的水平显著高于健康人群(SMD:1.81,95%CI:1.26~2.36,P<0.01)。经亚组分析发现普通患者与对照、重症患者与对照、危重患者与对照的SMD及95%CI分别为:1.69(0.92~2.45)、1.92(1.01~2.83)、1.85(-0.35~4.04)。结论血清TNF-a参与EV71手足口病发病的病理过程,可能是EV71型手足口病潜在的生物学标志。

[Objective]To explorer the relationship between serum tumor necrosis factor α（TNF-α） and hand,foot and mouth disease（HFMD） infected with EV 71,provide a theoretical basis for clinical diagnosis.[Methods]The case control study related to the relationship between serum TNF-α and HFMD infected with EV71 were searched the database including Pub Med,Web of Science,Cochrane Library,CNKI,Wanfang,VIP from January to June 2006. Stata 14.0 software were used to meta-analysis and to estimate comprehensive effects standardized mean difference（SMD） and 95%confidence interval（CI）.[Results]Nine articles were included in this research with 685 patients and 252 controls. The meta analysis showed that the serum TNF-α level of HFMD patients infected with EV71 was higher than that in health persons（SMD：1.81,95% CI： 1.26-2.36,P〈0.01）.The results of subgroup analysis showed that SMD and 95%CI for normal cases vs control persons,server cases vs control persons,and critical cases vs control persons were respectively 1.69（0.92-2.45）,1.92（1.01-2.83）,and 1.85（-0.35-4.04）.[Conclusion]TNF-α plays a role in the pathogenesis of HFMD infected with EV71 that may be used as an potential indicator for HFMD infected with EV71.