特纳综合征与甲状腺疾病相关性的Meta分析

发布时间：2018-01-04 03:36

  本文关键词：特纳综合征与甲状腺疾病相关性的Meta分析　出处：《兰州大学》2016年硕士论文　论文类型：学位论文

  更多相关文章： 特纳综合征 甲状腺疾病 相关性 发病率 Meta分析

【摘要】：目的:系统评价特纳综合征(TS)与甲状腺疾病之间的相关性及特纳综合征患者中甲状腺疾病的发病特征,为开展甲状腺疾病监测和随访工作提供科学依据。方法:计算机检索PubMed(1966~2016.2)、Web of Science(1980~2016.2)、The Cochrane Library(~2016.2)、EMBASE.com(1974~2016.2)、中国维普期刊资源数据库VIP.com(1989~2016.2)、中国万方学术数据库wangfangdata.com(1997~2016.2)、相关期刊论文CNKI(1994~2016.2)、中国生物医学文献数据库CBM(1978~2016.2),并辅以手工检索会议论文及追踪纳入研究的参考文献。2名研究人员依据已制定的纳入排除标准,独立进行研究文献的筛选、研究资料的提取和研究质量的评价,采用Stata12.0和RevMa5.3软件进行Meta分析合并OR值、发病率等研究指标,绘制森林图和漏斗图,并进行敏感性分析和发表偏倚分析。结果:(1)特纳综合征与甲状腺疾病相关性的Meta分析结果:最终纳入9篇病例-对照研究,共计1705例患者,特纳综合征组(TS组)731例,非特纳综合征组(NS组)974例。Meta分析结果显示:①特纳综合征与甲状腺功能异常之间存在显著相关性OR=15.35(95%CI:8.42,27.97);②特纳综合征与甲状腺自身抗体(TAA)阳性之间存在相关性OR=7.16(95%CI:4.70,10.90);③依据特纳综合征染色体核型进行亚组分析,结果显示单体核型、等臂核型、其他核型均与甲状腺自身抗体阳性相关[OR=7.37(95%CI:4.24,12.82);OR=20.48(95%CI:7.21,58.16);OR=7.36(95%CI:3.16,17.13)],表明无论特纳综合征患者染色体核型如何变化,均与甲状腺自身抗体阳性密切相关。(2)特纳综合征合并甲状腺疾病发病率的Meta分析结果:最终纳入30篇研究,其中病例-对照研究9篇,病例系列研究21篇,共计4487例特纳综合征患者。Meta分析结果显示:特纳综合征合并甲状腺功能异常的总发病率为22%(95%CI:0.18,0.26),特纳综合征合并甲状腺功能减退的总发病率为20%(95%CI:0.17,0.24);特纳综合征合并甲状腺自身抗体阳性的总发病率为37%(95%CI:0.31,0.43)。亚组分析显示:①国内和国外特纳综合征合并甲状腺功能异常的发病率分别为26%(95%CI:0.18,0.35)和19%(95%CI:0.15,0.22),两组间有显著差异(P0.05)。②单体核型、等臂核型、其他核型特纳综合征患者合并甲状腺自身抗体阳性的发病率分别为40%(95%CI:0.34,0.46)、58%(95%CI:0.43,0.73)和29%(95%CI:0.21,0.370),其中等臂核型TS患者TAA阳性的发病率高于单体核型和其他核型,三种核型间有显著差异(P0.05);③不同年龄段(≤10岁和10岁)特纳综合征患者TAA阳性的发病率分别为25%(95%CI:0.15,0.35)和40%(95%CI:0.14,0.66),两年龄段间有显著差异(P0.05)。结论:现有证据表明,特纳综合征与甲状腺疾病存在相关性;特纳综合征合并甲状腺疾病的发病率较高且随年龄增加有上升趋势,在不同地区、染色体核型间存在差异。
[Abstract]:Objective: to evaluate the relationship between TSX and thyroid diseases and the characteristics of thyroid diseases in patients with Turner syndrome. To provide scientific basis for thyroid disease monitoring and follow-up. Methods: PubMedus 1966 / 2016.2 was searched by computer. Web of Science 1980 / 2006 / 2 / the Cochrane Library. EMBASE.com1974 / 2016 / 2, VIP.com, China's WIP Journal Resource Database, 1989 / 2016.2). Wangfangdata.com1997 and CNKI1994-2016.2China Journal Full-Text Database (CNKI). China Biomedical Literature Database (CBM: 197819 / 2016.2). And assisted by manual retrieval of conference papers and tracking into the study of reference .2 researchers according to the established inclusion exclusion criteria for independent screening of research literature. Research data extraction and research quality evaluation, using Stata12.0 and RevMa5.3 software for Meta analysis combined OR value, morbidity and other research indicators. The sensitivity analysis and publication bias analysis were performed. Results Meta analysis of the association between Turner's syndrome and thyroid disease was carried out. Nine case-control studies were conducted. A total of 1705 patients were included in this study. 731 patients in TS group were treated with Turner syndrome. Meta-analysis of 974 cases of NS in non-Turner syndrome group. The results of meta-analysis showed that there was a significant correlation between Thyroid dysfunction and Thyroid dysfunction (OR15.35) (. 95CI: 8.42. 27.97; (2) there was a correlation between Turner's syndrome and thyroid autoantibody (TAA) positive. 3 according to chromosome karyotype analysis of Turner's syndrome, the results showed that monomeric karyotype, isobaric karyotype and other karyotypes were correlated with thyroid autoantibody positive. [Org 7.37 / 95 CI: 4.24 / 12.82; The order is 20.48 / 95. I am 7.21 and 58.16; The results show that no matter how the chromosome karyotype changes in the patients with Turner's syndrome. The results of Meta analysis on the incidence of Turner syndrome with thyroid disease were as follows: 30 studies were included, 9 of them were case-control studies. Case series 21 studies. Meta-analysis of 4487 patients with Turner syndrome showed that the total incidence of Turner syndrome with thyroid dysfunction was 2295 CI: 0.180.26). The total incidence of Turner syndrome with hypothyroidism was 20% CI: 0.17% 0.24%; The total incidence of Turner syndrome with thyroid autoantibody was 37% CI: 0.31. Subgroup analysis showed that the incidence of Turner's syndrome associated with thyroid dysfunction in China and abroad was 26% and 95%: 0.18, respectively. 0.35) and 19.95% CI: 0.15 / 0.22, there are significant differences between the two groups in P0.052.Monomeric karyotype and isobaric karyotype. The incidence of thyroid autoantibody positive in other karyotypic Turner syndrome patients was 400.95% CI: 0.34 0.46% 0.58% 95 CI: 0.43. The incidence of TAA positive in patients with isobaric karyotype TS was higher than that in monomeric karyotype and other karyotype. There was significant difference among the three karyotypes (P0.05). 3The incidence of TAA positive in patients with Turner syndrome in different age groups (鈮，

本文编号：1376876