摘要
目的采用Meta分析方法评价系统性红斑狼疮(SLE)患者血清抗内皮细胞抗体(AECA)阳性率、优势比(OR)及探讨阳性率异质性的来源。方法计算机联合手工规范检索建库至2020年8月1日中国学术期刊全文数据库、万方数据库、维普数据库、中国生物医学文献数据库、PubMed和Embase数据库中符合研究目的的中英文文献。根据纳入、排除标准筛选文献,采用纽卡斯尔-渥太华量表评估文献质量,提取研究数据,采用R 3.5.1软件进行Meta分析。结果最终纳入41项研究,共有1970例SLE患者(病例组),1796例健康者(对照组)。Meta分析显示,病例组血清AECA阳性率为56.4%(95%CI:48.10~64.70),I^(2)=95.00%,高于对照组[OR=34.03(95%CI:21.79~53.14),P<0.01,I^(2)=49.34%],异质性来源为酶联免疫吸附试验;其中,病例组血清IgG型AECA阳性数占ACEA总阳性数的58.8%(95%CI:48.10~69.50),IgA型AECA占33.2%(95%CI:26.70~39.70),IgM型AECA占12.7%(95%CI:2.60~22.70),IgG型AECA阳性数占比高于IgA型、IgM型(P<0.001);SLE患者血清AECA水平与系统性红斑狼疮疾病活动指数评分呈正相关[r=0.349(95%CI:0.23~0.46),P<0.001,I^(2)=15.20%];狼疮肾炎患者与神经精神狼疮患者AECA阳性率差异无统计学意义(P=0.69)。结论AECA可能参与了SLE血管损害的发生发展,且血清AECA水平与SLE病情活动度相关,可用于SLE病情活动度的随访监测;SLE中以IgG型AECA升高为主,临床运用中应对其重点关注。
Objective To evaluate the positive rate of serum anti-endothelial cell antibody(AECA)and odds ratio(OR)in patients with systemic lupus erythematosus(SLE)using Meta analysis method and to investigate the source of the heterogeneity of positive rate.Methods The Chinese and English literatures meeting the research purpose in CNKI,Wanfang,VIP,CBM,PubMed and Embase databases from the establishment of the database to August 1,2020 were searched by computer combined with manual standard.According to the inclusion and exclusion criteria,the literature was screened,the NOS scale was used to evaluate the quality of the literature,the research data was extracted,and the R 3.5.1 software was used for Meta analysis.Results Finally,a total of 41 studies were included,with 1970 SLE patients(case group)and 1796 healthy people(control group).Meta analysis showed that the positive rate of serum AECA in the case group was 56.4%[(95%CI:48.10-64.70),I^(2)=95.00%],which was higher than that in the control group[OR=34.03(95%CI:21.79-53.14),P<0.01,I^(2)=49.34%],the source of heterogeneity was enzyme-linked immunosorbent assay.Among them,the percentage of serum IgG type AECA positive cases in total AECA positive cases in the case group was 58.8%(95%CI:48.10-69.50),IgA type AECA accounting for 33.2%(95%CI:26.70-39.70),and IgM type AECA accounting for 12.7%(95%CI:2.60-22.70),the percentage of IgG type AECA positive cases was higher than those of IgA type and IgM type AECA(P<0.001).There was a positive correlation between serum AECA level and SLE disease activity index score in patients with SLE[r=0.349(95%CI:0.23―0.46),P<0.001,I^(2)=15.2%].There was no significant difference in the positive rate of AECA between patients with lupus nephritis and neuropsychiatric lupus(P=0.69).Conclusion AECA may be involved in the occurrence and development of SLE vascular damage,and serum AECA levels are related to SLE disease activity,and could be used for follow-up monitoring of SLE disease activity.In SLE,the IgG type AECA is mainly elevated,which should be paid attention to in clinical application.
作者
赵维庆
王兴强
刘爽
付李胤且
罗玉立
廖莉
娄雪
徐健
ZHAO Weiqing;WANG Xingqiang;LIU Shuang;FU Liyinqie;LUO Yuli;LIAO Li;LOU Xue;XU Jian(Department of Rheumatology and Immunology,the First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650032,China;Department of Rheumatology,the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine/Yunnan Provincial Clinical Medicine Research Center of Rheumatism in TCM,Kunming,Yunnan 650021,China)
出处
《国际检验医学杂志》
CAS
2022年第2期134-142,共9页
International Journal of Laboratory Medicine
基金
国家自然科学基金项目(81760296)
云南省科技厅科技计划项目[2019FF002(-082)]
云南省卫生科技计划项目(2018NS0133、2018NS0046)
云南省“万人计划”青年拔尖人才项目(YNWR-QNBJ-2018-152)。
关键词
系统性红斑狼疮
抗内皮细胞抗体
检测方法
阳性率
META分析
systemic lupus erythematosus
anti-endothelial cell antibody
detection method
positive rate
Meta analysis
