急性缺血性脑卒中患者血清白细胞介素-33水平变化及其与预后相关性的Meta分析

Changes of serum interleukin-33 levels and its correlation with prognosis in patients with acute ischemic stroke:A meta-analysis

目的探讨缺血性脑卒中(cerebral ischemic stroke,CIS)患者血清白细胞介素-33(interleukin-33,IL-33)水平变化及其在评估CIS患者预后中的价值。方法检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Cochrane library、Embase以及Web of Science数据库收录的有关CIS患者血清IL-33水平变化的临床对照研究,检索时间均为建库至2022-10-20。按照文献纳入与排除标准筛选文献,依据纽卡斯尔-渥太华量表对纳入的研究进行质量评价。采用RevMan5.4软件进行Meta分析,比较CIS患者与健康对照组间以及CIS患者不同预后者间血清IL-33水平的差异。结果共纳入19篇文献,其中16篇文献探究了急性CIS患者血清IL-33水平的变化,涉及1590例CIS患者和健康体检者971人;7篇文献探究了IL-33在CIS预后中的价值,涉及882例CIS患者,其中535例预后良好和347例预后不良。血清IL-33水平与CIS相关性的Meta分析结果显示,与健康体检者相比,CIS患者血清IL-33水平升高(SMD=2.24,95%CI:0.95~3.53;P<0.01);血清IL-33评估CIS患者预后的Meta分析结果显示,与预后良好组相比,预后不良组患者血清IL-33降低(SMD=1.14,95%CI:0.29~1.99;P<0.01)。结论CIS患者血清IL-33水平升高,且IL-33升高与患者预后良好有关,提示血清IL-33在诊断和评估CIS患者预后中具有一定临床价值。

Objective To investigate the changes of serum interleukin-33(IL-33)levels in patients with cerebral ischemic stroke(CIS)and its value in evaluating the prognosis of CIS patients.Methods The controlled clinical studies on the changes of serum IL-33 levels of patients with CIS included in China CNKI,Wanfang,VIP,China Biomedical Literature Database,PubMed,Cochrane library,Embase and Web of Science databases were retrieved from the database until October 20,2022.Articles were screened for inclusion and exclusion criteria,and the Newcastle-Ottawa scale was used to evaluate the quality of included studies.Meta-analysis was performed using RevMan5.4 software to compare the differences of serum IL-33 levels between CIS patients and healthy control groups as well as between different prognoses in CIS patients.Results A total of 19 articles were included,of which 16 articles explored the changes of serum IL-33 level in patients with acute CIS,involving 1590 patients with CIS and 980 healthy subjects;Seven articles explored that prognostic value of IL-33 in CIS,involving 882 patients with CIS,of which 535 had a good prognosis and 347 had a poor prognosis.The results of meta-analysis of the correlation between serum IL-33 and ischemic stroke showed that compared with healthy subjects,the serum IL-33 level in patients with ischemic stroke was significantly higher,the difference was statistically significant(SMD=2.24,95%CI:0.95-3.53;P<0.01).The results of meta-analysis of serum IL-33 in evaluating the prognosis of patients with ischemic stroke showed that compared with the good prognosis group,the serum IL-33 in the poor prognosis group was significantly lower,and the difference was statistically significant(SMD=1.14,95%CI:0.29-1.99;P<0.01).Conclusions Serum IL-33 levels are elevated in patients with CIS,and this elevation is associated with a favorable prognosis,suggesting serum IL-33 has diagnostic and prognostic utility in CIS patients.