5，10-亚甲基四氢叶酸还原酶C677T基因多态性与不明原因复发性流产相关性的Meta分析  

A meta analysis on correlation between polymorphisms of methylenetetrahydrofolate reductase and unexplained recurrent spontaneous abortion

作　　者：张丹[1,2] 王韦韦[1] 张宏秀[1] 

机构地区：[1]南京医科大学第一附属医院妇产科,210029 [2]江苏省昆山市淀山湖人民医院妇产科

出　　处：《中国计划生育学杂志》2017年第2期80-87,111,共8页Chinese Journal of Family Planning

摘　　要：目的:评价5,10-亚甲基四氢叶酸还原酶(MTHFR)C667T基因多态性与不明原因复发性流产(URSA)的相关性。方法:在PubMed数据库、中国知网数据库(CNKI)、万方数据库、中国生物医学文献数据库(CBM)和维普中文期刊全文(VIP)数据库中全面检索关于MTHFR C667T基因多态性与URSA相关的文献,按照既定的筛选标准进行筛选,对纳入的文献进行质量评价,并采用RevMan5.3软件进行meta分析。结果:共有31篇文献被纳入本次的meta分析,累计病例组3706人,对照组3937人。meta分析结果显示MTHFR C677T基因多态性与URSA的发生呈相关性T/C:OR=1.41,95%CI 1.23~1.61,P<0.05;CT/CC:OR=1.23,95%CI 1.03~1.47,P<0.05;(TT+CT)/CC:OR=1.45,95%CI 1.21~1.74,P<0.05;TT/CC:OR=1.98,95%CI 1.51~2.59,P<0.05)。病例组与对照组有统计学差异(P<0.05)。在亚组分析中发现,国内人群中基因型为TT的女性发生URSA的风险较基因型为CC的女性高3.56倍,基因型TT和等位基因T是URSA的遗传性风险因素TT/CC:OR=3.56,95%CI 2.71~4.69,P<0.05;T/C:OR=1.88,95%CI 1.66~2.13,P<0.05;CT/CC:OR=1.67,95%CI 1.36~2.04,P<0.05;(TT+CT)/CC:OR=2.07,95%CI 1.71~2.50,P<0.05,病例组与对照组的差异均有统计学意义(P<0.05),但在国外人群中,包括亚洲其他国家人群中,各基因型分布URSA病例组与正常对照组差异并无统计学意义(P>0.05)。结论:MTHFR C667T基因多态性与URSA呈相关性,在中国人群中MTHFR C667T基因多态性是URSA的遗传性高风险因素,但在国外人群中包括亚洲其他国家中并未显示相关性,仍有待加大样本进一步论证。Objective： To analyze correlation between polymorphisms of the 5, 10 methylenetetrahydrofolate reductase （MTHFR） C667T and unexplained recurrent spontaneous abortion （URSA）. Methods： Literatures of correlation between polymorphisms of MTHFR C667T and URSA were comprehensively searched in database such as PubMed, CNKI, Wanfang,CBM and （VIP）. Literature screening was conducted according to the included criteria, literatures quality was evaluated, and the RevMan 5.3 software was used for meta-analysis. Results： A total of 31 literatures were included, and 3706 subjects were in URSA group, and 3937 subjects were in healthy control group. The results showed that the polymorphism of MTHFR C677T was correlated with URSA （T/C ： OR=1.41, 95%CI 1.23-1.6,P〈0.05; CT/CC：OR=1.23 ,95%CI 1.03-1.47,P〈0.05;（TT＋CT）/CC： OR=1.45, 95%CI 1.21-1.74,P〈0.05;TT/CC： OR = 1.98, 95%CI 1.51-2.59, P〈0.05）. There was significant difference between URSA group and healthy control group （P〈0.05） ; The risk of URSA of domestic women with genotype TT was 3.56 times higher than that of domestic women with genotype CC when subgroup analysis was conducted. Genotype TT and allele T genetic were the risk factors of URSA （TT/CC： OR= 3.56, 95%CI 2.71-4.69, P〈0.05; T/C： OR=1.88, 95%CI 1.66-2.13, P〈 0.05; CT/CC： OR=1.67, 95%CI 1.36-2.04, P〈0.05; （TT＋CT）/CC： OR=2.07, 95%CI 1.71-2.50, P〈0.05）, and there was significant different between URSA group and healthy control group （P〈0.05）, but there was no significant different between URSA group and healthy control group for foreign women, which including other Asian women （P〉0.05）. Conclusion.. The gene polymorphism of MTHFR C667T is associated with URSA. And gene polymorphism of MTHFR C667T is the high risk factor of URSA for Chinese women, but there is no any correlation with foreign women including other Asian women.

关 键 词：5 10-亚甲基四氢叶酸还原酶 基因多态性 不明原因复发性流产 META分析 

分 类 号：R714.21[医药卫生—妇产科学]