血清同型半胱氨水平与慢性心力衰竭相关性的Meta分析

发布时间：2018-01-24 04:51

本文关键词： 同型半胱氨酸慢性心力衰竭心脏射血分数 Meta分析　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本文通过Meta分析的方法,系统评价血清同型半胱氨酸(Homocysteine,HCY)水平与慢性心力衰竭(Chronic heart failure,CHF)的相关性,探讨HCY对慢性心力衰竭的预测价值,为临床提供循证医学证据。方法:将“同型半胱氨酸/Homocysteine、慢性心力衰竭/Chronic heart failure”做为检索主题词,再查找相对应的自由词构建检索表达式,对Pubmed、Medline、Embase、The Cochrane library、Web of Science、中国生物医学文献数据库(CBM)、相关期刊论文(CNKI)、维普数据库(VIP)、万方(WANFANG)等数据库逐一进行检索。检索文献无语言限制,检索时间均为自数据库建立起至2017年3月31日为止。文献筛选的过程由两名研究人员独立完成,应用Rev Man5.3软件对各统计量进行统计学分析。结果:本次Meta分析共检索到607篇文献,最终纳入文献7篇,共纳入1037例心衰患者。首先,在未排除其他干扰因素的前提下,针对HCY进行单因素统计分析,异质性分析显示,P0.00001,I2=99%,说明各研究之间异质性显著,故采用随机效应模型,结果显示【合并效应量WMD=5.43,95%CI(3.09,7.76),P0.00001】,Z=4.56,且P0.00001,说明该研究结果有统计学意义,即血清HCY升高是慢性心力衰竭发生和发展的独立危险因素,对于慢性心力衰竭的诊断具有很大价值。随后,我们又将射血分数(ejection fraction,EF)小于40%纳入试验组的统计变量中,进行多因素统计分析,共纳入6篇文献,其中试验组703人,对照组2808人。异质性分析显示,I2=9 8%,P0.00001,说明各研究之间异质性显著,依然采用随机效应模型,结果显示【合并效应量WMD=4.77,95%CI(1.75,7.79),P=0.002】,Z=3.09,且P0.01,说明该研究结果有统计学意义,即血清HCY升高是慢性心力衰竭发生和发展的独立危险因素,且血清HCY水平与心脏射血分数呈负相关性。结论:1、血清同型半胱氨酸水平升高是慢性心力衰竭发生和发展的独立危险因素,对于慢性心力衰竭的诊断、治疗具有很大价值。2、血清同型半胱氨酸水平与心脏射血分数呈负相关性。
[Abstract]:Objective: to evaluate homocysteine homocysteine in serum by Meta analysis. To explore the predictive value of HCY in chronic heart failure (CHF). Methods: "homocysteine / homocysteine". Chronic heart failure / chronic heart failure "as a search theme word, and then find corresponding free words to construct the search expression, on the Pubmed." Medline Embase the Cochrane libraryweb of Science, Chinese Biomedical Literature Database (CBM). The full text databases of Chinese periodicals, such as CNKI, Weip, WANFANGand etc, are searched one by one. There are no language restrictions on the retrieval of literature. The retrieval time was from the establishment of the database to March 31st 2017. The process of literature screening was completed by two researchers independently. Results: a total of 607 articles were retrieved in this Meta analysis, and 7 papers were included. A total of 1 037 patients with heart failure were included. First of all, without excluding other interference factors, univariate statistical analysis of HCY was carried out. Heterogeneity analysis showed that P0.00001 + I2P was 99%. The results of random effect model show that the combined effect quantity WMD5.439 / 95CII 3.09 / 7.76 / P0.00001). ZG 4.56, and P0.00001, show that the results of this study are statistically significant, that is, elevated serum HCY is an independent risk factor for the occurrence and development of chronic heart failure. This is of great value for the diagnosis of chronic heart failure. Subsequently, we included a fraction of ejection fraction (EF) less than 40% in the statistical variables of the trial group. A multivariate statistical analysis was carried out, including 703 subjects in the experimental group and 2808 in the control group. Heterogeneity analysis showed that there was no significant difference between the two groups (P 0.00001). The results showed that there was significant heterogeneity among the various studies, and the random effect model was still used. The results showed that [the combined effect quantity WMD4.77 / 95CII 1.75 / 7.79 / P0. 002]. ZH3. 09 and P0. 01 indicate that the results of this study are statistically significant, that is, elevated serum HCY is an independent risk factor for the occurrence and development of chronic heart failure. Conclusion the elevated serum homocysteine level is an independent risk factor for the occurrence and development of chronic heart failure. The serum homocysteine level was negatively correlated with cardiac ejection fraction.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.6

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