脑脊液中CXCL13与临床孤立综合征及多发性硬化关系的Meta分析

发布时间：2018-04-20 19:44

本文选题：临床孤立综合征 + 多发性硬化　；参考：《山西医科大学》2014年硕士论文

【摘要】：目的评价脑脊液（CSF）中CXCL13与临床孤立综合征（CIS）及多发性硬化（MS）的关系。方法计算机检索Pubmed（1966－2013）、Embase（1974－2013）、Ovid（1993-2013）、Cochrane中心临床对照试验注册数据库（CENTRAL）（2013年第四期）、中国生物医学文献数据库（CBMdisc）（1978－2013）、CNKI（1979－2013）、VIP（1989－2013）以及万方数据库（1978－2013）等，收集关于CXCL13与临床孤立综合征及多发性硬化关系的队列研究及病例对照研究。按Cochrane系统评价的方法，由2名研究人员分别对所纳入的文献进行独立的质量评价以及资料的提取和筛选，对文献的数据进行Meta分析、定性评价。通过Cochrane协作网提供的RevMan5.2软件进行Meta分析，通过对异质性的检验来选择固定效应模型或随机效应模型，估计综合评价指标95%的置信区间9，检验水准为α=0.05。结果本研究共纳入6篇的文献，样本量为1011例，其中病例组（多发性硬化及临床孤立综合征）为721例，对照组（神经系统非炎性疾病[NND]）为290例。Meta分析研究结果显示：（1）多发性硬化（MS）组与NND相比，MS组患者的CSF中CXCL13水平明显升高（P0.00001）；（2）MS组与临床孤立综合征（CIS）组相比，MS组患者的CSF中CXCL13水平明显升高（P0.00001）；（3）随访2年，转化为MS的CIS组与未转化的CIS组相比，转化为MS的CIS组患者的CSF中CXCL13水平明显升高（P=0.009）；（4）CSF中CXCL13水平10pg／mL的CIS组患者，转化为MS的转化率高于CSF中CXCL13水平10pg／mL的CIS组患者（P=0.0005）。结论与NND组及CIS组相比，MS组的CSF中CXCL13水平明显升高，与未转化的CIS组相比，转化为MS的CIS组的CXCL13水平明显升高，且CIS患者CSF中CXCL13水平越高，MS的转化率就越高，因此，CSF中CXCL13的水平与CIS及MS的发生发展有关，且对CIS转归为MS有重要的预测价值。本次Meta分析的纳入研究相对偏少，纳入的研究文献质量偏低，可能存在选择性偏倚、信息偏倚和混杂偏倚，对结论的可靠性造成一定影响，，我们期待更多审计严谨的高质量流行病学研究对结果进行进一步验证。
[Abstract]:Objective to evaluate the relationship between CXCL13 and clinical solitary syndrome (CISIS) and multiple sclerosis (MS) in cerebrospinal fluid (CSF). Methods computer search was conducted for Pubmedan (1966-2013) Embase (1974-2013) and Wanfang (1978-2013VIP1989-2013), and CENTRALL (2013 fourth issue, Chinese Biomedical Literature Database, 1978-2013VIP1989-2013) and Wanfang Database (1978-2013), respectively, for Cochrane Central Clinical controlled trial Registration Database (CENTRALL), China Biomedical Literature Database (CBMdisct) 1978-2013. Cohort studies and case-control studies on the relationship between CXCL13 and clinical solitary syndrome and multiple sclerosis were collected. According to the method of Cochrane system evaluation, two researchers carried out independent quality evaluation, data extraction and screening, Meta analysis and qualitative evaluation of the literature data. Through the Meta analysis of RevMan5.2 software provided by Cochrane cooperation network, the fixed effect model or random effect model is selected by testing the heterogeneity, and the confidence interval of 95% of the comprehensive evaluation index is estimated to be 9, and the test level is 伪 0.05. Results A total of 6 articles were included in this study. The sample size was 1011 cases, including 721 cases in the case group (multiple sclerosis and clinical solitary syndrome). A meta-analysis of 290 patients with neurological non-inflammatory diseases (NND). The results of Meta-analysis showed that the level of CXCL13 in CSF in the MS group was significantly higher than that in the NND group and that in the MS group was significantly higher than that in the MS group and the clinical isolated syndrome group. The level of CXCL13 in CSF was significantly increased (P 0.00001) and followed up for 2 years. Compared with the non-transformed CIS group, the CSF CXCL13 level in the CIS group was significantly higher than that in the non-transformed CIS group, and the CXCL13 level in the CIS group was significantly higher than that in the CIS group with the CXCL13 level in CSF, and the CXCL13 level in the 10pg/mL group was higher than that in the CIS group with the 10pg/mL level in the CSF. The level of CXCL13 in the CIS group was significantly higher than that in the CIS group with the 10pg/mL level in the CSF. Conclusion compared with NND group and CIS group, the level of CXCL13 in CSF in MS group was significantly higher, and the CXCL13 level in CIS group was significantly higher than that in untransformed CIS group, and the higher CXCL13 level in CIS patients was, the higher the transformation rate of MS was. Therefore, the level of CXCL13 in CSF is related to the occurrence and development of CIS and MS, and has important value in predicting the outcome of CIS to MS. The inclusion of Meta analysis is relatively small, the quality of the research literature is low, and there may be selective bias, information bias and mixed bias, which has a certain impact on the reliability of the conclusions. We look forward to further validation of the results by more rigorous and high-quality epidemiological studies.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R744.51

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