血清新蝶呤对冠心病预后预测价值的Meta分析

Predictive value of serum neopterin for the prognosis of coronary heart disease: A meta-analysis

目的:系统评价血清新蝶呤与冠心病预后的关系。方法:计算机检索PubMed、EMbase、The Cochrane Library、中国知网及万方数据库,查找所有血清新蝶呤与冠心病预后相关的文章,检索时限从建库到2021年1月31日,同时手工检索纳入研究的参考文献。由两名评审员按文献的纳入及排除标准独立完成文献筛选、数据提取,用Revman 5.2软件进行Meta分析。结果:在最初检索的402篇的文献中,9篇符合纳入标准,共13 901例患者。Meta分析显示:血清新蝶呤水平升高对冠心病患者的预后有预测作用(HR=1.48,95%CI:1.25~1.75)。血清新蝶呤对死亡和复合不良心血管事件有预测作用(分别为HR=1.24,95%CI:1.10~1.40和HR=2.07,95%CI:1.24~1.76)。亚组分析显示:血清新蝶呤对冠心病患者预后的价值随着时间的延长而逐渐增大。结论:血清新蝶呤与冠心病的预后有关,尤其可以预测复合心血管不良事件及死亡。同时,血清新蝶呤对冠心病患者预后的价值随着时间的延长而逐渐增大。

Objective: To assess the prognostic value of serum neopterin in coronary heart disease(CHD).Methods: We searched Pubmed, EMBASE, The Cochrane Library, CNKI, and WanFang database to find literature on the relationship between serum neopterin and prognosis of coronary heart disease from inception to January 31, 2021. At the same time, we searched reference lists of relevant articles by hand. Assessment and data extraction were conducted by two experienced reviewers independently. And then, Meta-analysis was performed by Revman 5. 2 software. Results: Of a total of 402 initial studies, we included 9 literature which included 13 901 patients. Meta-analysis showed that high serum neopterin levels could predict prognosis of patients with coronary heart disease(HR=1. 48,95%CI: 1. 25-1. 75). Serum neopterin is a predictor of death and adverse cardiovascular events(HR=1. 24, 95%CI: 1. 10-1. 40;HR=2. 07, 95%CI: 1. 24-1. 76). Subgroup analysis showed that the value of serum neopterin on the prognosis of patients with CHD gradually increased with development of time. Conclusion: Serum neopterin detetion is valuable in relation to the prognosis of CHD, and especially in the prediction of composite adverse cardiovascular events and death. At the same time, the value of serum neopterin on the prognosis of patients with CHD gradually increased with development of time.