我国儿童HLA-DQA1基因多态性与幽门螺杆菌感染关系的Meta分析  

Meta-analysis on Relationship between HLA-DQA1 Gene Polymorphism and Helicobacter Pylori Infection in Chinese Children

作　　者：张铁民[1] 张天哲 陈银苹 朱红俐 陈晓青[1] 

机构地区：[1]唐山钢铁集团有限责任公司医院儿科,河北唐山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,河北唐山063000

出　　处：《医学综述》2015年第20期3759-3763,共5页Medical Recapitulate

基　　金：唐山市科学技术研究与发展指导项目(111302092a;12130294b)

摘　　要：目的采用Meta分析的方法综合评价中国儿童HLA-DQA1基因多态性与幽门螺杆菌(Hp)感染的关联性。方法以"幽门螺杆菌""HLA-DQA1""基因多态性""儿童"为检索词,从中国生物医学文献数据库(CBMdisc)、清华同方(CNKI)系列数据库、维普数据库(VIP)、万方数据库、Pubmed和Medline数据库,全面检索1995年1月至2015年1月国内外正式刊物上公开发表的有关HLA-DQA1与中国儿童Hp感染的病例对照研究的文献,应用Rev Man 5.0软件对符合筛选标准的研究以OR值作为效应指标,根据异质性检验结果选择相应模型进行综合定量分析。结果符合纳入标准的共11项病例对照研究,共计Hp感染组445例和正常对照组317例。对11项研究中涉及较多的HLA-DQA1*0101,0102,0103,0104,0201,0301,0302,0401,0501,0601共10个位点进行了Meta分析。经综合分析:1HLA-DQA1*0103和HLA-DQA1*0301可能为中国儿童Hp感染的易患性基因OR合并及其95%CI分别为1.77(1.18,2.64),P=0.005;1.80(1.09,2.98),P=0.02;2HLADQA1*0104和HLA-DQA1*0302位点存在异质性,按民族进行亚组分析,结果为:对于HLA-DQA1*0104,HLA-DQA1*0302位点汉族组间无异质性,而少数民族组仍有异质性,亚组结果显示,HLADQA1*0302可能是我国汉族儿童的保护基因[OR合并及其95%CI为0.50(0.26,0.98),P=0.040];HLA-DQA1*0104可能是少数民族儿童感染易患基因[OR合并及其95%CI为2.15(2.13,3.77),P=0.007];3换用模型对其进行敏感性分析显示,除HLA-DQA1*0104和HLA-DQA1*0301两位点结论发生改变外,其余位点结论均未发生变化。而剔除小样本后进行敏感性分析显示结论均未发生改变。敏感性分析结果表明结果较可靠。结论中国儿童Hp感染可能与HLA-DQA1*0103和HLADQA1*0301位点有关联,未发现其余位点与感染有关。Objective To assess the associations of HLA-DQA1 gene polymorphism with Helicobacter pylori（Hp） infection in Chinese children through meta-analysis. Methods Articles published from 1995 to 2015 on the relationship between HLA-DQA1 gene polymorphism and Helicobaeter pylori infection were searched from CBMdisc, CNKI database, VIP database, Wanfang database, Pubmed and Medline, using the searching terms of ＂Helicobacter pylori＂ ＂HLA-DQA1 gene polymorphism＂ ＂ children＂, etc. The results were quantitatively analyzed by RevMan 5.0 seftware,the pooled odds ratio（OR） were calculated by choo- sing FLxed effect model or random effect mode,according to the result of Heterogeneity test. Results A total of 445 children with Helicabacter pylori infection and 317 uninfected healthy controls were included from 11 studies. Meta-analysis were conducted in the following gene loci：HLA-DQA1 ＊ 0101,0102,0103,0104,0201, 0301,0302,0401,0501,0601. After comprehensive analysis ： ①HIA-DQA1 ＊ 0103 and HLA-DQA1 ＊ 0301 alleles were the risk factors of Hp infection,the values of pooled odds ratio were 1. .77（95% CI 1.18-2. 64, P = 0. 005 ） and 1.80 （ 95 % CI 1.09-2.98, P = 0.02 ） respectively. ②Subgroup-analysis： the results of sub- group analyses based on nationality showed ：for HLA-DQA1 ＊ 0104 and HLA-DQA1 ＊ 0302 no heterogeneity was observed in Han nationality group, but not in minority group as to HLA-DQA1 ＊ 0302. In addition, statis- tical difference was found after subgroup analyses in the Han nationality group. HLA-DQA1 ＊ 0302 alleles were the protection factors against Hp infection, and the values of pooled odds ratio were 0.50 （95 % CI 0. 26- 0. 98 ,P =0.04）. HLA-DQA1 ＊ 0104 alleles were the susceptible factors against helicobacter pylori infection in the minorities, and the values of pooled odds ratio were 2.15 （95 % CI 2. 13 -3.77, P = 0. 007 ）. ③Sensitiv- ity analysis ： almost all the conclusions were not changed except for the DQA1 ＊ 0104 and DQA1 ＊ 0301 when

关 键 词：幽门螺杆菌感染 人类白细胞抗原Ⅱ HLA-DQA1 基因多态性 META分析 

分 类 号：R573[医药卫生—消化系统]