血管紧张素转换酶基因I/D多态性与成人急性肺损伤/急性呼吸窘迫综合征发生及预后相关性的Meta分析  

Association between Insertion/Deletion Polymorphism in Angiotensin-Converting Enzyme Gene and Acute Lung Injury/Acute Respiratory Distress Syndrome in Adults:A Meta-Analysis

作　　者：高飞[1] 董亮[1] 严洁[1] 

机构地区：[1]南京医科大学附属无锡人民医院重症医学科,江苏无锡214023

出　　处：《中国呼吸与危重监护杂志》2016年第1期43-48,共6页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的探讨血管紧张素转换酶（ACE）基因I/D多态性与成人急性肺损伤（ALI）/急性呼吸窘迫综合征（ARDS）患病率及病死率的关系。方法应用Meta分析方法对共计498例成人ALI/ARDS患者、3 220例健康对照人群及1 137例非ALI/ARDS人群的ACE基因多态性（II、ID、DD）与ALI/ARDS发病率及病死率的8个研究结果进行综合定量分析。根据异质性结果采用随机效应模型或固定效应模型,计算合并比值OR值及其95%可信区间（95%CI）。结果与健康对照组及疾病对照组相比,ACE I/D基因多态性与ALI/ARDS的发病率均无关。在亚洲人群中,ACE I/D基因型与ALI/ARDS的病死率相关,等位基因I/D、基因型II/II＋ID及基因型DD/II＋ID的合并OR值分别为2.99（95%CI 1.87-4.76,P〈0.05）、0.36（95%CI 0.20-0.67,P〈0.05）及4.62（95%CI 1.71-12.45,P〈0.05）。结论 D等位基因可能是亚洲人群ALI/ARDS患者病死的高危因素。Objective To assesse the association of an insertion/deletion （ I/D） polymorphism in the angiotensin-converting enzyme gene （ ACE） with the risk and the mortality of acute lung injury （ ALI） / acute respiratory distress syndrome （ ARDS） . Methods We searched electronic databases through April 2014 for the terms “angiotensin-converting enzyme gene”, “acute lung injury” and “acute respiratory distress syndrome”, and reviewed all studies that reported the relationship of the I/D polymorphismin ACE with ALI/ARDS in adults. Eight studies met the inclusion criteria, comprising 498 ALI/ARDS patients, 3220 healthy controls and 1137 patients without ALI/ARDS. Three genetic models were used： the allele, dominant and recessive models. The meta-analysis was performed with RevMan 5. 2 software.Results The ACE I/D polymorphism was not associated with susceptibility to ALI/ARDS compared with the healthy controls and the patient controls for any genetic model. The ACE I/D polymorphism was associated with the mortality risk of ALI/ARDS in Asian subjects, and OR was 2. 99 （ 95% CI 1. 87 - 4. 76, P 〈 0. 05） , 0. 36 （ 95% CI 0. 20 - 0. 67, P 〈 0. 05） , 4. 62 （ 95% CI 1. 71 - 12. 45, P 〈 0. 05） for allele I/D, genotype II/ II ＋ ID and genotype DD/ II ＋ ID, respectively. Conclusion There is a possible association between the ACE I/D polymorphism genotype and the mortality risk of ALI/ARDS in Asians.

关 键 词：血管紧张素转化酶 急性肺损伤 急性呼吸窘迫综合征 META分析 

分 类 号：R563.8[医药卫生—呼吸系统]