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目的采用Meta分析的方法综合评价中国儿童HLA-DQB1基因多态性与幽门螺杆菌感染的关联性。方法全面检索1995年1月—2015年1月国内外正式刊物上公开发表的有关HLA-DQB1与中国儿童幽门螺杆菌感染的病例对照研究的文献,应用RevMan5.0软件进行综合定量分析。结果符合纳入标准的共9项病例对照研究,共计幽门螺杆菌感染组388例和正常对照组296例。对7篇文献含9项研究中涉及的HLA-DQB1*0201,0301,0302,03032,04,05,0602共7个位点进行了Meta分析。经综合分析:1HLA-DQB1*03032和HLA-DQB1*04可能为中国儿童幽门螺杆菌感染的易感和抵抗基因(OR=0.53,95%CI:0.30~0.95,P=0.03;OR=1.68,95%CI:1.03~2.74,P=0.02);2HLA-DQB1*03032位点存在异质性,异质性检验结果为χ2=18.73,P=0.02,I2=57%;按民族进行亚组分析后,结果显示仅在汉族健康儿童中Hp感染与HLA-DQB1*03032有关联,OR合并及其95%CI为0.43(0.22,0.86),表明HLA-DQA1*03032可能是我国汉族儿童的抵抗基因;按疾病分亚组后,也表现为HLADQB1*03032位点在健康儿童中仍和Hp感染有关,OR合并及其95%CI为0.38(0.15,0.95)。进一步在汉族儿童中按是否患胃相关疾病分组和进一步在健康儿童中按汉族与少数民族分组发现,各研究均不再存在异质性,且HLA-DQB1*03032位点和汉族健康儿童Hp感染有关,OR合并及其95%CI为0.20(0.10,0.37)。总之亚组分析显示是否患有胃相关疾病、不同民族可能是其产生结果异质性的原因。3换用模型或去除小样本研究对其进行敏感性分析,发现除各位点结论均未发生变化,结果较可靠。结论中国儿童幽门螺杆菌感染可能与HLA-DQB1*03032和HLA-DQB1*04位点有关联,民族及是否患有胃相关疾病是造成各研究结果异质性的原因。
Objective To evaluate the association between HLA-DQB1 gene polymorphism and Helicobacter pylori infection in Chinese children by Meta-analysis. Methods A comprehensive case-control study of HLA-DQB1 infection in children with Helicobacter pylori infection in children from January 1995 to January 2015 in China and foreign countries was searched. A comprehensive quantitative analysis was performed using RevMan 5.0 software. Results A total of 9 case-control studies that met the inclusion criteria were included, with a total of 388 cases of Helicobacter pylori infection and 296 cases of normal controls. Seven articles including 7 HLA-DQB1 * 0201,0301,0302,03032,04,05,0602 genes involved in 9 studies were analyzed by meta-analysis. The results of comprehensive analysis: 1HLA-DQB1 * 03032 and HLA-DQB1 * 04 may be susceptible and resistant genes of Helicobacter pylori infection in Chinese children (OR = 0.53,95% CI: 0.30-0.95, P = 0.03; OR = Heterogeneity of 2HLA-DQB1 * 03032 loci was χ2 = 18.73, P = 0.02, I2 = 57%. According to the national subgroup analysis The results showed that only H. pylori infection was associated with HLA-DQB1 * 03032 in Han healthy children. The OR combination and its 95% CI was 0.43 (0.22, 0.86), indicating that HLA-DQA1 * 03032 may be the resistance gene of Chinese Han children ; According to the disease sub-subgroup, it also showed that HLADQB1 * 03032 was still associated with Hp infection in healthy children. OR combined and its 95% CI was 0.38 (0.15,0.95). Furthermore, according to the group of Han-children with or without gastric-related diseases and further analysis of Han and minority groups in healthy children, we found no heterogeneity in all the studies, and HLA-DQB1 * 03032 was associated with Hp infection in healthy Han children For the OR combination and its 95% CI 0.20 (0.10, 0.37). In short, subgroup analysis shows whether there is a stomach-related disease and different ethnic groups may be responsible for the heterogeneity of their outcomes. 3 for the model or remove the small sample of its sensitivity analysis and found that in addition to the conclusion of each site did not change, the result is more reliable. Conclusion Helicobacter pylori infection in Chinese children may be related to HLA-DQB1 * 03032 and HLA-DQB1 * 04 loci. Whether ethnicity and gastric-related diseases are the causes of heterogeneity in the results of the studies.