β肾上腺素能受体自身抗体、M_2毒蕈碱受体自身抗体与“特发性”心律失常之间的关系的Meta分析  

Comorbid association of autoantibodies against beta-adrenoceptors,against M_2-muscarinic and“Idiopathic”arrhythmia:a meta-analysis

作　　者：古丽美拉.沙吾提 张玲[1] 周贤惠[1] 汤宝鹏[1] Gulimeila Shawuti;ZHANG Ling;ZHOU Xianhui;TANG baopeng(Department of Cardiac Pacing and Electrophysiological,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院心脏起搏电生理科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2018年第7期820-825,共6页Journal of Xinjiang Medical University

基　　金：国家自然科学基金(81670292);2016年留学人员科技活动项目择优资助经费(优秀类)

摘　　要：目的荟萃分析β肾上腺素能受体自身抗体(β-AR自身抗体)、M_2毒蕈碱受体自身抗体(M_2R自身抗体)与"特发性"心律失常之间的关系。方法通过检索CNKI中国期刊全文数据库、万方数据库、Pubmed数据库、ISI Web of Science数据库搜索研究,不限制语言和年份(建库至2017年11月),并根据纳入标准进行筛选。2名研究者独立从所纳入研究中提取数据。质量评估采用修改后的纽卡斯尔-渥太华量表(NOS)进行。采用Stata.12软件进行统计学分析。采用漏斗图检测其发表偏倚。结果共纳入12个研究。累积病例608例,对照组534例,荟萃分析结果显示:"特发性"心律失常患者病例组与对照组相比,β-AR自身抗体、M_2R自身抗体水平更高。10篇文章质量评分均≥5分,为较高质量文献。6篇报告了β-AR自身抗体阳性率,合并显示,异质性检验I_2=56.4%,P=0.043,P<0.05,存在轻度异质性,用随机效应模型,合并的OR有统计学意义(OR=8.24,95%CI:3.83~17.72,Z=5.4,P=0.00)。2篇文献通过计算可获得β-AR自身抗体水平的均数标准差,进行合并,结果显示合并的SMD有统计学意义(SMD=0.82,95%CI:0.36~1.29,Z=3.48,P=0.001)。3篇文献通过计算可获得M_2R自身抗体水平均数标准差,合并显示,异质性检验I_2=63.6%,P=0.064,不存在异质性,用随机效应模型,合并的SMD有统计学意义(SMD=0.95,95%CI:0.57~1.33,Z=4.89,P=0.000)。结论 "特发性"心律失常患者中β-AR自身抗体、M_2R自身抗体检出率更高。Objective To evaluate the comorbid association between autoantibodies against beta-adrenoceptors（β-AR）autoantibodies,against M2-muscarinic（M2 R）autoantibodies and＂Idiopathic＂arrhythmia.Methods A retrospective study was conducted through searching PubMed,ISI Web of Science and China National Knowledge Infrastructure,Wanfang database without restricting the languages and year（up to October 2016）and data were screened based on the inclusion criteria.Two authors independently extracted data from the included studies.Quality assessment was carried out by using Newcastle-Ottawa Scale（NOS）.A meta-analysis was made with Stata 12 software.Publication bias was evaluated via visualization of funnel plots.Results A total of 12 studies were included,with 608 migraineurs and 534 healthy controls.The meta analysis showed that the patients with＂idiopathic＂arrhythmia were higher in the level of theβ-AR autoantibodies and M2 R autoantibodies,compared with the healthy control group.The quality scores of the 10 articles were≥5,meaning they were higher quality documents.6 studies reported positive rates ofβ-AR autoantibodies,the combination showed that heterogeneity test was I2=56.4%（P =0.043）,with mild heterogeneity;in using the random effect model,the combined OR was statistical significance（OR =8.24,95%CI：3.83-17.72,Z=5.4,P =0.00）.The standard deviation of the level of theβ-AR autoantibody could be obtained by calculation in the 2 references.The results showed that the combined SMD was statistically significant（SMD=0.82,95%CI：0.36-1.29,Z=3.48,P =0.001）.The standard deviation of the level of M2 R autoantibody could be obtained by calculation in 3 articles,the combination showed that heterogeneity test,I2=63.6%（P =0.064）,without exist heterogeneity;in using the random effect model,the combined SMD was statistical significance（SMD=0.95,95%CI：0.57-1.33,Z = 4.89,P =0.000）.Conclusion The presence ofβ-AR autoantibodies and M2 R autoantibodies was obvious in＂Idiopathic＂arrhythmi

关 键 词：β-AR自身抗体 M2R自身抗体 心律失常 Meta 

分 类 号：R541.7[医药卫生—心血管疾病]