P-选择素与房颤及房颤合并血栓的Meta分析

Meta-analysis of P-selectin and atrial fibrillation and atrial fibrillation complicated with thrombosis

目的评价P-选择素与房颤及房颤合并血栓之间的相关性,以期为房颤及其并发症的诊断评估提供证据。方法制定检索策略,检索中文数据库(CNKI数据库、维普数据库、万方数据库)和英文数据库(Pubmed,Cochrane图书馆,Webof Science)建库至2020年9月的文献,筛选P-选择素与房颤及房颤合并血栓之间的病例-对照试验,提取数据,采用RevMan 5.4软件分析。结果最终纳入25项研究,房颤患者2049人,房颤合并血栓的共363人,对照组1638人。Meta分析显示房颤血栓组和房颤组比较,P-选择素的浓度(SMD=1.57,95%CI:0.46~2.69,P=0.006)、房颤组和对照组比较,P-选择素的浓度(SMD=1.01,95%CI:0.64~1.39,P<0.00001);P-选择素基因-2123C>G位点等位基因遗传模型(OR=1.41,95%CI:1.10~1.81,P=0.007)、纯合子遗传模型(OR=2.20,95%CI:1.03~4.70,P=0.04)可能是房颤患者发生血栓事件的危险因素;房颤组和对照组比较,-2123C>G位点各类遗传模型差异无统计学意义(P>0.05)。结论P-选择素浓度及P-选择素-2123C>G位点多态性与房颤及房颤血栓事件相关。

Objective To evaluate the correlation between P-selectin and atrial fibrillation and atrial fibrillation complicated with thrombosis,so as to provide evidence for the diagnosis and evaluation of atrial fibrillation and its complications.Methods To make search strategy,and search Chinese database(CNKI database,VIP database,Wanfang database)and English database(Pubmed,Cochrane Library,Web of Science)from September 2020,screen case-control trials between P-selectin and atrial fibrillation and atrial fibrillation complicated with thrombosis,extract data,and analyze with RevMan 5.4 software.Results Totally 25 studies were included,including 2049 patients with atrial fibrillation,363 patients with atrial fibrillation complicated with thrombosis and 1638 controls.In comparison between atrial fibrillation thrombus group and atrial fibrillation group,the concentration of P-selectin had statistical significance(SMD=1.57,95%CI:0.46-2.69,P=0.006);in comparison between the atrial fibrillation group and control group,the concentration of P-selectin had statistical significance(SMD=1.01,95%CI:0.64-1.39,P<0.00001);allele genetic model of PS gene-2123C>G locus(OR=1.41,95%CI:1.10-1.81,P=0.007)and homozygous genetic model(OR=2.20,95%CI:1.03-4.70,P=0.04)may be the risk factors for thrombosis in patients with atrial fibrillation.In comparison between atrial fibrillation group and control group,the genetic models of PS gene-2123C>G locus had no statistical significance(P>0.05).Conclusion P-selectin concentration and polymorphism of P-selectin-2123C>G locus are associated with atrial fibrillation and atrial fibrillation thrombus events.