内皮功能与颗粒物短期暴露的Meta分析  

Endothelial function and short-term exposure to particulate matter in air: a Meta-analysis

作　　者：阮燕萍[1] 梁瑞娟[2] 廉慧[1] 刘啸乐[1] 范中杰[1] 

机构地区：[1]北京协和医学院北京协和医院心血管内科,北京100730 [2]深圳市人民医院心血管内科,深圳518020

出　　处：《中国循证心血管医学杂志》2016年第3期273-279,共7页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的系统评价颗粒物短期暴露与内皮功能的相关性。方法以空气污染与内皮功能相关指标,包括充血反应指数(RHI)、血流介导血管舒张(FMD)和硝酸甘油介导的血管舒张(NMD)为关键词通过计算机检索Pub Med、EMBASE、Cochrane library和Web of Science电子数据库。经2名研究者独立提取各入组研究的资料和评价指标。通过随机效应模型综合分析,结果表示为PM2.5每升高10μg/m3,黑炭(BC)每升高1μg/m3所导致的内皮功能指标变化。结果符合入组标准的文献共有12篇。Meta分析结果表明PM2.5每增加10μg/m3,FMD降低0.27%(P=0.046),分组分析发现PM2.5滞后1 d FMD变化最明显。亚组分析表明该效应可被以下因素所修饰,包括美国人、年龄低于55岁人群、女性的比例低于50%和定群追踪研究设计的组别效应更明显。评估BC与内皮功能的两项研究的Meta分析结果表明BC每增加1μg/m3,肱动脉直径减少0.07 mm,NMD减少2.46%(P=0.005、P=0.043),并没有发现BC与FMD的相关性。结论短期暴露于PM2.5和黑炭与内皮功能下降相关,这为空气污染所致心血管疾病风险增加提供证据。Objective To review systematically the correlation between short-term exposure to particulate matter in air and endothelial function. Methods The databases of PubMed, EMbase, Coehrane Library and Web of Science were retrieved with computer taken relevant indexes of air pollution and endothelial function including reactive hyperemia index （RHI）, flow-mediated dilation （FMD） and nitroglycerin-mediated dilatation （NMD） as keywords. The data and review indexes were extracted from included studies by 2 independent researchers. The pooled analysis in random effect mode] indicated the changes of endothelial function indexes induced by each increment of PM2.5 （10μ g/m3） and each increment of black carbon （BC, 1μg,/m3）. Results There were totally 12 documents eligible to the criteria. The results of Meta-analysis showed that as PM25 increased by 10 μ g/m3 per time, FMD decreased by 0.27% （P=0.046）. The grouping analysis showed that FMD changed the most significantly when duration of exposure to particulate matter was delayed 1 d. The subgroup analysis indicated that the above effect could be modified by following factors： American, population aged below 55 and population with female percentage below 50%, and the effect was more significant in groups with grouping tracking design. The results of Meta-analysis for reviewing BC and endothelial function showed that as BC increased by 1 μg/m3 per time, brachial artery diameter decreased 0.07 mm and NMD decreased by 2.46% （P=0.005, P=0.043）. The correlation between BC and FMD was observed. Conclusion The decrease of endothelial function is correlated to short-term exposure to PM25 and BC, which provide the evidence of air pollution improving risk of cardiovascular diseases.

关 键 词：内皮功能 血流介导的血管舒张 心血管疾病 颗粒物 META分析 

分 类 号：R543[医药卫生—心血管疾病]