CD4^+T淋巴细胞亚群与冠心病关系的Meta分析

Meta analysis of the relationship between CD4^+T Lymphocyte subsets and coronary heart disease

目的:系统评估CD4+T淋巴细胞亚群功能失调和冠状动脉粥样硬化性心脏病(CHD)的关系,为心血管病的临床预防和诊治提供依据。方法:计算机检索PubMed、GeenMedical、Cochrane图书馆、万方数字化期刊数据库和中国知网数据库(CNKI),收集国内外公开发表有关CD4+T淋巴细胞亚群失衡与冠心病的研究,2名研究者独立筛选和评估,统计学分析采用RevMan5.3软件。结果:共入选17篇文献,共2 535例。Th1细胞在急性心肌梗死(AMI)、不稳定型心绞痛(UA)与对照组及AMI与稳定型心绞痛(SA)的比较中均明显升高SMD分别为[3.21 (1.91, 4.50)]、[2.71 (1.68, 3.73)]、[-3.04(-4.40,-1.68)],SA与对照组比较无明显升高SMD[0.25 (-0.11, 0.61)];Th2细胞在AMI、UA、SA与对照组及AMI与SA的比较中均无明显差异,SMD分别为[0.08 (-0.19,0.35)]、[0.14 (-0.13,0.40)]、[0.26(-0.02,0.54)]、[0.17 (-0.11,0.45)];Th17细胞在AMI、UA与对照组及AMI与SA的比较中均明显升高,SMD分别为[3.51 (2.52, 4.50)]、[3.59 (2.65, 4.54)]、[-2.78 (-3.51,-2.05)],SA与对照组比较无明显升高SMD[1.07 (0.50, 1.65)];Treg细胞在AMI、UA与对照组及AMI与SA的比较中均明显降低,SMD分别为[-3.88 (-5.07,-2.70)]、[-2.95 (-4.09,-1.82)]、[3.46 (2.41, 4.50)],SA与对照组比较无明显升高SMD[-1.03 (-1.59,-0.48)]。结论:CHD患者存在CD4+T淋巴细胞亚群比例失衡,免疫功能失调与CHD的疾病过程密切相关。

Purpose To systematically evaluate the relationship between the dysfunction of CD4^+T lymphocyte subsets and(CHD) in patients with coronary atherosclerotic heart disease, and to provide basis for clinical prevention and treatment of cardiovascular diseases. Methods: Computer search of PubMed, GeenMedical, Cochrane Library, Wanfang Digital Journal Database and China knowledge Network Database(CNKI), collected studies on the imbalance of CD4^+T lymphocyte subsets and coronary heart disease published at home and abroad. Two researchers were screened and evaluated independently, and statistical analysis was made by RevMan5.3 software. Results: A total of 17 articles with a total of 2535 cases were selected. Compared with the control group and AMI and SA, the SMD of Th1 cells increased significantly in AMI, UA and SA, respectively. SMD was 3.21,2.71, and-3.04, respectively. Compared with the control group, there was no significant increase in SMD [0.25(-0.11,0.61)] in SA compared with the control group. There was no significant difference in Th2 cells between AMI, UA, SA and control group, and between AMI and SA, and the SMD was [0.08(-0.19,0.35)]、[0.14(-0.13,0.40)]、[0.26(-0.02,0.54)]、[0.17(-0.11,0.45)], respectively. Th17 cells increased significantly in AMI, UA and control group, and between AMI and SA. The SMD was [3.51(2.52, 4.50)]、、[-2.78(-3.51,-2.05)], respectively. Compared with the control group, SA had no significant increase in SMD [1.07(0.50, 1.65)]. Treg cells in AMI, UA and control group and AMI and SA were significantly decreased, SMD were [-3.88(-5.07,-2.70)]、[-2.95(-4.09,-1.82)]、[3.46(2.41, 4.50)] respectively. Compared with control group, SA had no significant increase in SMD [-1.03(-1.59 quotient 0.48)]. Conclusions: There is an imbalance in the proportion of CD4^+T lymphocyte subsets in patients with CHD, and the imbalance of immune function is closely related to the disease process of CHD.