血清YKL-40水平对冠心病诊断价值的Meta分析

Diagnostic Value of Serum YKL-40 Level for Coronary Artery Disease:A Meta Analysis

目的分析血清甲壳质酶蛋白(YKL-40)水平对冠心病的诊断价值。方法检索PubMed、EBSCO、中国生物医学文献数据库(SinoMed)和万方数据知识服务平台(WanFang Data)数据库,同时辅以手动检索等,搜集血清YKL-40水平与冠心病相关性的病例-对照研究,检索时限均为建库至2018年11月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件对检索并入选的国内外15篇文献进行综合定量分析。结果与对照组相比,冠心病病人的血清YKL-40水平更高[SMD=1.95,95%CI(1.15,2.75),P<0.00001];按不同国家进行亚组分析结果显示,中国、韩国和丹麦人群中,冠心病病人血清YKL-40水平与对照人群血清YKL-40水平比较差异有统计学意义,冠心病病人表达更高[中国:SMD=2.08,95%CI(0.89,3.26),P=0.0006;韩国:SMD=0.65,95%CI(0.16,1.14),P=0.009;丹麦:SMD=0.81,95%CI(0.54,1.08),P<0.00001],然而土耳其和波兰人群冠心病病人和对照人群YKL-40水平则无统计学意义[土耳其:SMD=4.48,95%CI(-2.85,11.82),P=0.23;波兰:SMD=0.20,95%CI(-0.22,0.61),P=0.35]。结论YKL-40有可能作为早期诊断冠心病的一项指标。

Objective To evaluate the value of serum YKL-40 in diagnosing coronary heart disease(CHD).Methods Literatures about serum YKL-40 for diagnosing CHD were retrieved from PubMed,EBSCO,SinoMed,and Wanfang Database from establishment of database to November 2018.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.RevMan software(Version 5.3)was chosen to deal with statistical data.Results Serum YKL-40 level in CHD patients was higher than that in control subjects[SMD=1.95,95%CI(1.15,2.75),P<0.00001],Ethnicity-stratified analysis indicated that,serum YKL-40 level in CHD patients were higher than that in control subjects among China,Korea,and Denmark populations[China:SMD=2.08,95%CI(0.89,3.26),P=0.0006;Korea:SMD=0.65,95%CI(0.16,1.14),P=0.009;Denmark:SMD=0.81,95%CI(0.54,1.08),P<0.00001],but not in Turkey and Poland populations[Turkey:SMD=4.48,95%CI(-2.85,11.82),P=0.23;Poland:SMD=0.20,95%CI(-0.22,0.61),P=0.35].Conclusion Serum YKL-40 level has high diagnostic value for CHD.