关于输血后丙型肝炎的系统评价和Meta分析  

META ANALYSIS OF PROSPECTIVE STUDIES ABOUT POSTTRANSFUSION HCV HEPATITIS

作　　者：魏中菲 栾明瀚 贾岩 关维俊 

机构地区：[1]河北省唐山市中心血站,063000 [2]华北理工大学附属医院 [3]华北理工大学公共卫生学院

出　　处：《中国煤炭工业医学杂志》2015年第6期998-1000,共3页Chinese Journal of Coal Industry Medicine

基　　金：国家卫生计划生育委员会(编号:201402021)

摘　　要：目的随着输血技术的成熟和完善,输血已经越来越广泛地应用到临床治疗中,然而,输血后相关传染病的发生也越来越普遍,丙型肝炎就是其中之一,目前丙型肝炎已经成为输血后肝炎的最主要类型,但由于丙型肝炎的发生受很多因素的影响,有学者提出了目前技术上的缺陷导致一些需输血的丙型肝炎患者在输血前漏诊,从而导致人们错误估计输血与丙型肝炎发生的相关性程度,因此,有必要开展相关研究。方法本文收集30年来有关输血和丙型肝炎的前瞻性研究,进行了Meta分析,从而总结出较精确的输血和丙型肝炎发生的相关性程度,并进行了系统性文献评价和Meta分析。结果应用固定效应模型估算出的合并后的相对危险度（relative ratio,RR）为16.30（95%CI15.71~16.88,P=0）,而且进入Meta分析的每个研究的总体RR〉1,这说明输血组的丙型肝炎发生率高于对照组,输血可造成丙型肝炎的发生率增高。结论漏斗图提示此Meta分析存在发表偏倚,这可能与很多因素有关,需要进一步研究,本Meta分析中纳入的研究有很多因素未详细说明,需要进一步研究,通过比较此Meta分析中的各研究中的RR值,发现严格与准确的输血前丙型肝炎检查对输血后丙型肝炎发生率的大小有影响。Objective As transfusion technique progressing, transfusion is extensively applied, which make posttransfusion infectious disease more popular. HCV hepatitis is the most common type of posttransfusion hepatitis, because of many reasons contributing to HCV hepatitis, some assume that the improper estimate about the relevance between transfusion and occurence of HCV hepatitis is improper,which is the result of miss diagnose attributed to the deficienee of current technique. So we make a meta analysis about prospec- tive studies in order to provide a more proper estimate about the relevance. Methods systematic review of articles and meta analysis. Results RRpooled （relative ratio） calculated by fixed - effect model is 16 . 30 （95 % CI 15.71~ 16.88, P = 0） and the lowest limit of 95 M CI of each study＇s RR is greater than 1, which indicate that incidence of HCV infected in posttransfusion patient is greater than control＇s. Above all,trans- fusion can increase the incidence of HCV infected among population. Conclusion funnel plot indicate that pubilication bias that may be associated with many resons exists in this meta analysis ,which need to be ex- plored. A lot of factors that influence the result of meta analysis in each study in this meta analysis didn＇t de- scribe in details,which need to be investigated. Because of the difference of RR in each study,we assume that the rigor and reliable HCV test before transfusion is associated with the incidence of HCV infected a- mong posttransfusion patient.

关 键 词：META分析 输血后丙型肝炎 前瞻性研究 相对危险度 

分 类 号：R512.63[医药卫生—内科学]