病毒性肝炎对帕金森病发病风险影响的Meta分析

Meta-analysis of the impact of viral hepatitis on the risk of Parkinson’s disease

目的探讨肝炎病毒感染(包括甲、乙、丙、丁、戊型肝炎病毒感染)对帕金森病(PD)发病风险的影响。方法在中、英文数据库中检索1965年1月-2019年10月报道的病毒性肝炎与PD发病风险间关系的文献。筛选文献后进行文献质量评价并提取比值比(OR)和95%可信区间(95%CI)等数据,采用STATA 12.0软件进行Meta分析。采用敏感性分析和Meta回归分析寻找异质性的来源。采用剪补法评估发表偏倚。结果总共纳入7篇文献。丙型肝炎病毒(HCV)感染为PD的危险因素(OR=1.19,95%CI=1.01~1.41,P=0.035)。抗HCV治疗后可降低PD发病风险(OR=0.67,95%CI=0.57~0.79,P<0.001)。乙型肝炎病毒(HBV)感染与PD发病风险无关(OR=0.96,95%CI=0.72~1.28,P=0.781)。结论HCV感染可能会增加PD发病风险,同时抗HCV治疗可降低PD发病风险。因此,临床上应重视对HCV感染患者的筛查及治疗,以降低PD发病率,减轻家庭、社会经济负担。

Objective To investigate the impact of viral hepatitis infections(including hepatitis A,B,C,D,and E infection)on the risk of Parkinson′s disease(PD).Methods Literatures on the relationship between viral hepatitis and the risk of PD from January 1965 to October 2019 were obtained by searching in Chinese and English databases.After screening the literatures,quality evaluation was performed and data such as odds ratio(OR)and 95%confidence interval(95%CI)were extracted.Meta-analysis was performed using STATA 12.0.Sensitivity analysis and meta-regression analysis were used to find the source of heterogeneity.Publication bias was assessed using the trim-and-fill method.Results A total of 7 articles were included for study.The analyses suggested that hepatitis C virus(HCV)infection is a risk factor for PD(OR=1.19,95%CI=1.01~1.41,P=0.035),anti-HCV treatment can reduce the risk of PD(OR=0.67,95%CI=0.57~0.79,P<0.001),and that hepatitis B virus(HBV)infection is not associated with the risk of PD(OR=0.96,95%CI=0.72~1.28,P=0.781).Conclusion HCV infection may increase the risk of PD,which can be reduced via anti-HCV treatment.Therefore,it is necessary to pay attention to the clinical screening and treatment of patients with HCV infection,so as to reduce the incidence of PD and relieve the economic burden for both the patients and the whole society.