我国儿童HLA-DQB1基因多态性与幽门螺杆菌感染关系的Meta分析  

META-ANALYSIS ON RELATIONSHIP BETWEEN THE GENE POLYMORPHISM OF HLA-DQB1 AND HELICOBACTER PYLORI INFECTION IN CHINESE CHILDREN

作　　者：张铁民[1] 张天哲 朱红丽[1] 陈晓青[1] 陈银苹 

机构地区：[1]唐山钢铁公司医院儿科,河北省唐山市063000 [2]华北理工大学公共卫生学院流行病与卫生统计学学科

出　　处：《中国煤炭工业医学杂志》2015年第8期1368-1374,共7页Chinese Journal of Coal Industry Medicine

基　　金：唐山市科技科学技术研究与发展指导项目(12130294b)

摘　　要：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腘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χ^2=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 explore the association the gene polymorphism of HLA-DQB1 with helicobacter pylori infection in Chinese children by a meta analysis.MethodsDatabases CNKI,CBM,WanFang DATA,MEDLINE and PubMed were searched using ＂ HLA-DQB1＂, ＂polymorphisms＂ or ＂alleles＂,in combination with ＂ helicobacter pylori infection＂,and a manual search of citations from relevant original studies and literature between January 1995 and Januar 2015 was also performed.RevMan 5.0 was applied in the process of analyzing the data of 9 case-control studies.Results Seven literatures were screened from the 9studies,and group of helicobacter pylori infection in a total of 388 cases and 296 cases of normal control group.Meta-analyses were conducted in the following gene loci：HLA-DQB1＊0201,0301,0302,03032,04,05,0602.The results showed that HLA-DQB1＊03032 and HLA-DQB1＊04 alleles were the related factors of helicobacter pylori infection,the values of pooled odds ratio were 0.53（95%CI：0.30-0.95,P=0.03 and1.68（95% CI：1.03-2.74,P=0.02）respectively.After Heterogeneity test,there existed heterogeneity in HLA-DQB1＊03032（χ^2=18.7,P=0.02,I2=57%）.The results of subgroup analyses based on nationality and disease showed：HLA-DQB1＊03032 alleles were the protection factors against helicobacter pylori infection in health children of Han nationality,and the values of pooled odds ratio were 0.20（95%CI：0.10-0.37）.Sensitivity analysis：almost all the conclusions were not changed when changing statistical model,while sensitivity analysis did not change the conclusions after removing the small sample,showing that the results are reliable.Conclusion The occurrence of helicobacter pylori infection is associated with the gene polymorphism of HLA-DQB1＊03032 and HLA-DQB1＊04 in Chinese children.

关 键 词：幽门螺杆菌感染 人类白细胞抗原Ⅱ HLA-DQB1 基因多态性 META分析 

分 类 号：R378[医药卫生—病原生物学]