血清腺苷脱氨酶与急、慢性肝炎关系的Meta分析  

Meta Analysis of the relationship between serum adenosine deaminase and acute, chronic hepatitis

作　　者：乔雪峰[1] 黄志平[2] 张云鹤 张宁[4] 高红军 岳志刚[1] 许慧[1] 

机构地区：[1]北京煤炭总医院检验科,100028 [2]北京煤炭总医院心脏中心,100028 [3]北京煤炭总医院妇产科,100028 [4]北京煤炭总医院口腔科,100028

出　　处：《中国综合临床》2017年第11期1003-1009,共7页Clinical Medicine of China

摘　　要：目的 评价血清腺苷脱氨酶（ADA）在急、慢性肝炎诊疗过程中的价值.方法 检索万方数据库、中国知网及Pubmed,从已发表的中、英文文献中筛选有关血清ADA与急、慢性肝炎间关系的文献,检索时间均自建库始至2016年12月1日止.纳入的文献经质量评价,采用Rewman5.2软件进行血清ADA水平与急、慢性肝炎间关系的Meta分析.结果 入选28篇文献包括急性肝炎患者1688例,慢性肝炎患者1843例;分析结果显示急性肝炎患者血清ADA水平及阳性率均高于慢性肝炎患者[MD=4.13,95%CI（0.43,7.84）,P=0.03和OR=1.94,95%CI（1.19,3.14）,P=0.007].漏斗图显示存在明显的发表偏倚,并可能会影响Meta分析的结论（P=0.001）.结论 异质性主要来自于临床异质性及统计学异质性;血清ADA水平检测对急、慢性肝炎诊疗具有一定价值.Objective To evaluate the role of serum adenosine deaminase in the diagnosis and treatment of acute,chronic hepatitis.Methods WanFang Data,CNKI and PubMed were retrieved in order to screen literature about the relationship between serum ADA and acute and chronic hepatitis,the retrieval time was from the beginning of the database to December 1st,2016.After evaluating quality of the included studies, the meta-analysis was conducted to analyze the relationship between the level of serum ADA and acute,chronic hepatitis via RevMan 5.2 software.Results A total of 28 articles were identified including 1688 cases with acute hepatitis and 1843 cases with chronic hepatitis.The results of meta-analysis showed that the levels and positive rate of serum ADA were significantly higher in the acute hepatitis groups than that in chronic hepatitis groups（MD=4.13,95%CI（0.43,7.84）,P=0.03;OR=1.94,95%CI（1.19,3.14）,P=0.007）.Funnel plots showed significant publication bias,and may have implications for Meta analysis（P=0.001）.Conclusion Heterogeneity of the literatures mainly comes from the clinical heterogeneity and statistical heterogeneity.The serum ADA has certain value in the diagnosis and treatment of acute and chronic hepatitis.

关 键 词：急性肝炎 慢性肝炎 肝炎 腺苷脱氨酶 

分 类 号：R446.1[医药卫生—诊断学] R575.1[医药卫生—临床医学]