多发性骨髓瘤与HBV及HCV感染相关性的系统评价

A systematic analysis of multiple myeloma and the related risk of HBV and HCV infection

目的通过系统评价分析探讨多发性骨髓瘤患者与HBV及HCV感染之间的相关性。方法分别在4个英文数据库(PubMed, Web of science,OVID,Cochrane Library)和3个中文数据库(CNKI, VIP,万方)中文系统检索文献,检索日期截至2016年9月。英文数据库检索的主题词为"multiple myeloma or MM and infection",中文数据库检索的主题词为"多发性骨髓瘤和感染"。文献质量评估应用Newcastle Ottawa Scale(NOS)。应用固定效应模型(异质性检验I^2<25%)或者随机效应模型(异质性检验I^2≥25%)估计总体比值比(OR)和95%可信区间(95%CI)。结果共有9项研究纳入Meta分析。研究发现多发性骨髓瘤患者发生HBV和HCV感染的机会增加,与对照组相比分别为3.17倍和4.16倍。多发性骨髓瘤组HBV感染(OR=3.17,95%CI:1.17～1.96,I^2=27%,P=0.002)和HCV感染(OR=4.16,95%CI:1.33～2.22,I^2=0%,P<0.001)与对照组比较差异有统计学意义(P<0.05)。结论 HBV和HCV感染是多发性骨髓瘤的危险因素,应在治疗前后高度重视并加以控制。

ObjectiveThis study aimed to assess the risk of hepatitis B virus （HBV） and hepatitis C virus （HCV） infection in patients with multiple myeloma （MM） by systematic analysis.MethodsThe literature was retrieved in 4 English databases （PubMed, Web of science, OVID, Cochrane Library） and 3 Chinese databases （CNKI, VIP, and Wanfang） as of september 2016. The key word in English/ Chinese database retrieval is ＂ MM or multiple myeloma and infection＂ . Newcastle Ottawa Scale （NOS） was used to evaluate the article quality. The overall odds ratio （OR） and 95% confidence intervals （95% CIs） were estimated by fixed （heterogeneity test at I2〈25%） or random （heterogeneity test at I2≥25%） effects model.ResultsA total of 9 studies were included in the Meta analysis. The study found that multiple myeloma patients had an increased risk of HBV and HCV infection, 3.17 and 4.16 times higher than the control group. HBV （OR=3.17, 95% CI： 1.17-1.96, I2=27%, P=0.002） and HCV infection （OR=4.16, 95% CI： 1.33-2.22, I2=0%, P〈0.001） in the multiple myeloma group were significantly different from those of the control group （P〈0.05）.ConclusionsHBV and HCV infection are risk factors for multiple myeloma and should be highly regarded and controlled before and after treatment.