重症新型冠状病毒肺炎与淋巴细胞相关性的Meta分析  

Correlation between lymphocytes and severe coronavirus disease 2019:a Meta-analysis

作　　者：谭辉 黄海兵[1,2] 罗瑞英 曾进 杨傲然[5] 卢涛 杨若青 邓雪松 Tan Hui;Huang Haibing;Luo Ruiying;Zeng Jin;Yang Aoran;Lu Tao;Yang Ruoqing;Deng Xuesong(School of Basic Medical,Chongying Three Gorges Medical College,Chongqing 404120,China;Chongqing Eingineering Research Center of Antineoplastic Natural Drugs,Chongqing 404120,China;Deportment of Surgery,Second Hospital of Lanzhou University,Lanzhou 730030,Gansu,China;Department of Surgery,Chongqing Three Gorges Central Hospial of Chongqing University,Chongging 404120,China;School of Public Health and Management,Chongqing Three Gorges Medical College,Chongqing 404120,China)

机构地区：[1]重庆三峡医药高等专科学校基础医学部,重庆404120 [2]重庆市抗肿瘤天然药物工程技术研究中心,重庆404120 [3]兰州大学第二医院普外科,甘肃兰州730030 [4]重庆大学附属三峡中心医院普外科,重庆404120 [5]重庆三峡医药高等专科学校公共卫生与管理学院,重庆404120

出　　处：《中国中西医结合急救杂志》2020年第5期518-523,共6页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：重庆市教委科研项目(KJQN201902701)。

摘　　要：目的 系统评价重症新型冠状病毒肺炎(简称新冠肺炎)与淋巴细胞的相关性.方法 利用计算机检索美国国立医学图书馆PubMed数据库、美国科学网(WebofScience)、荷兰医学文摘Embase数据库、Cochrane图书馆数据库、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据和维普数据库(VIP)中有关新冠肺炎患者淋巴细胞计数变化的病例对照研究;检索时限均从建库至2020年4月18日.英文检索词为Coronavirus Disease2019、novel coronavirus pneumonia、coronavirus2019、COVID-19、2019-nCoV、SARS-CoV-2、laboratory、lymphocyte、Clinical Characteristics等;中文检索词为新型冠状病毒肺炎、新冠肺炎、新冠病毒、2019冠状病毒病、2019新型冠状病毒感染、新冠肺炎、2019-nCoV肺炎、新型冠状病毒、实验检查、淋巴细胞、临床特征等.由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata15.0软件进行Meta分析.通过Begg检验并绘制漏斗图评价发表偏倚.结果 共纳入21篇文献,涉及3243例患者,其中包括重症755例,非重症2488例.Meta分析结果显示:重症新冠肺炎患者淋巴细胞计数显著降低〔加权均数差(WMD)=-0.39,95%可信区间(95%CI)为-0.46--0.32,P<0.0001〕;7项研究报告了淋巴细胞计数降低比例,淋巴细胞减少与重症新冠肺炎患病风险明显相关〔优势比(OR)=3.84,95%CI为1.72-8.57,P=0.001〕.漏斗图显示,纳入文献的效应点基本呈漏斗形,分布比较对称;Begg检验结果P=0.432,提示发表偏倚较小,结果较可靠.结论 淋巴细胞计数及比例降低与重症新冠肺炎风险增加密切相关,可作为病情恶化的重要临床指标,为重症新冠肺炎诊疗提供新思路.Objective To syslematically evaluate the corelation between lymphoeyte and severe cormnavinus disease 2019(COVID-19).Methods A computer was used to relrieve the literatures of case-contml studies on lymphocyte count in patients with COVID-19 in the following databases:American National Medical Library Center for Biotechnology Information PubMed Database,American Web of Science,Holland medical Digest Database Embase,Coehrane Library Database,China National Knowledge Infrastructure(CNKI),China Biology Medicine Literature database(CBM),WanFang Data and VIP Datahase;the retrieval time limit was from the date of respective database establishment to April 18,2020.the English search terms were"Coronavirus Disease 2019""novel coronavirus pneumonia""coronavirus 2019""COVID-19""2019-nCoV""SARS-CoV-2""laboratory""lymphoeyte""Clinical Characteristics",ete.:the Chinese search terms were translated into English as follows:"nowel coronavirus pneumonia""novel coronavirus""coronavinus disease 2019""COVID-19""2019 novel coronavirus infection""2019-nCoV"."laboratory examination""lymphoryte""dinical characteristics",ete.After two researchers independently screened the selected literatures,extracted data and asessed the risk of bias in the enrolled studies,then meta-analysis was performed by using Stata 15.0 software.The publication bias was evaluated through Becke test and drawn funnel chart.Results A lotal of 21 case-control studies involving 3243 cases including 755 severe COVID-19 patients and 2488 cases of nonA tolal of 21 case-control studies involving 3243 patients:755 severe COVID-19 patients and 2488 patients of non severe type.The results of meta-analysis showed that lymphocyte count was signifcantly lower in patients with severe COVID-19 [weighted mean difference(WMD)=-0.39,95% confidence interval(95%CI)was-0.46 to-0.32.P<0.0001];there were 7 studies reporting data on rate of lymphocyte count deerease.and the resuls showed that a decrease of lymphocyte count was significantly corelated with the risk of severe COVID-19[odds

关 键 词：新型冠状病毒肺炎 重型 淋巴细胞 相关性 META分析 

分 类 号：R72[医药卫生—儿科]