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目的采用Meta分析探讨活动期系统性红斑狼疮(SLE)患者调节性T细胞(Treg)的改变。方法计算机检索PubMed及中国生物医学文献数据库(CBM)中公开发表的中英文文献,检索时限均为从建库至2013年8月31日,对符合纳入标准的研究进行质量评价及数据提取后,采用Comprehensive-Meta Analysis(CMA)v2.2软件进行Meta分析。结果共纳入22个病例-对照研究,其中有12个研究报道了调节性T细胞(Treg)数量变化,12个研究报道了Treg占CD4+T细胞的比例变化。结果显示,活动期SLE患者较健康者外周血中,调节性Treg数量降低1.23%(WMD=-1.23%,95%CI=-1.87%~-0.59%),以Treg表面标志物的不同进行亚组分析,结果显示CD4+CD25+Treg数量减少1.56%(WMD=-1.56%,95%CI=-2.18%~-0.94%),CD4+CD25highTreg数量减少0.91%(WMD=-0.91%,95%CI=-1.52%~-0.29%);活动期SLE患者较健康者外周血中,Treg占CD4+T细胞的比例变化与对照组相比无统计学差异。敏感性分析显示结果稳健性好,未有发表偏倚。结论当前证据表明,SLE可能更主要的是Treg的数量减少所致,而不是T细胞中Treg比例异常所致的免疫功能的改变。
Objective To investigate the changes of regulatory T cells (Tregs) in patients with active systemic lupus erythematosus (SLE) by Meta-analysis. Methods Chinese and English documents published in PubMed and Chinese Biomedical Literature Database (CBM) were retrieved by computer. The search time was from the database to August 31, 2013. After quality evaluation and data extraction of the eligible studies, Meta-analysis was performed using the Comprehensive-Meta Analysis (CMA) v2.2 software. Results Twenty-two case-control studies were included, of which 12 reported changes in the number of regulatory T cells (Tregs) and 12 reported changes in Tregs in CD4 + T cells. The results showed that the number of Tregs in peripheral blood of active SLE patients decreased by 1.23% (WMD = -1.23%, 95% CI = -1.87% -0.59%), and the Tregs were different in peripheral blood The results showed that the number of CD4 + CD25 + Tregs decreased by 1.56% (WMD = -1.56%, 95% CI = -2.18% -0.94% CI = -1.52% -0.29%). There was no significant difference in the proportion of Tregs to CD4 + T cells in peripheral blood of active SLE patients compared with healthy controls. Sensitivity analysis showed good robustness and no publication bias. Conclusions Current evidence suggests that SLE may be more important due to a reduction in the number of Tregs than to changes in immune function resulting from aberrant Tregs in T cells.