柯萨奇病毒感染和1型糖尿病的风险关系Meta分析  

Meta-analysis of the relationship between Coxsackie virus infection and the risk of type 1 diabetes

作　　者：杨森 代晓玲 张臻 赵碧英 张祎俐 崔岚巍[1] YANG Sen;DAI Xiao-ling;ZHANG Zhen;ZHAO Bi-ying;ZHANG Yi-li;CUI Lan-wei(Department of Pediatrics, the First Qunli Branch Affiliated Hospital of Harbin Medical University, Harbin 150070, China;Department of Pediatrics, Children′s Hospital of Soochow University, Soochow 215003, China)

机构地区：[1]哈尔滨医科大学附属第一医院群力院区儿科,黑龙江哈尔滨150070 [2]苏州大学附属儿童医院儿科,江苏苏州215003

出　　处：《河北医科大学学报》2021年第5期568-574,602,共8页Journal of Hebei Medical University

基　　金：国家重点研发计划重大慢性非传染性疾病防控研究(2016YFCI305301)。

摘　　要：目的系统评价柯萨奇病毒感染与1型糖尿病(type 1 diabetes mellitus,T1DM)的风险关系。方法按照PICOs原则构建检索问题,使用主题词和自由词全面检索Pubmed、EmBase、SinoMed、中国知网、万方数据库、维普网。检索时间自建库至2020年5月28日。使用Newcastle Ottawa Scale评价纳入文献质量;Revman 5.3软件包绘制森林图和漏斗图。通过随机效应模型(I2>50%)或固定效应模型(I2<50%)计算纳入文献的比值比(odd ratios,OR)和95%置信区间(95%confidence interval,95%CI)。评价结果包括柯萨奇病毒感染感染及各亚型(1~6型)和1型糖尿病的风险关系,不同研究地区、不同年龄和不同柯萨奇病毒感染检测方法检测方法对柯萨奇病毒感染和T1DM风险关系的影响。结果根据纳入和排除标准,共检索到372篇文献。剔除与研究主题不相关的文献312篇,浏览全文后排除36篇试验设计不严谨的文献。最终,对24篇文献进行系统评价和Meta分析,其中1篇文献无数据可利用。总样本量为3306例,病例组1693例,对照组1613例。分析结果显示T1DM患者感染柯萨奇病毒B组感染的风险是对照组的5倍(OR=4.49,95%CI:2.69~7.50,I2=85%)差异有统计学意义,T1DM患者感染柯萨奇病毒B组1型的风险是对照组的1.56倍(OR=1.56,95%CI:1.20~2.03,I2=0%),柯萨奇病毒B组的检测方法对结果影响较大。结论目前证据提示柯萨奇病毒B组感染与T1DM发病有统计学相关性,柯萨奇病毒B组感染可能是T1DM发病的一个病因或促进T1DM的发生。Objective To systematically evaluate the risk relationship between Coxsackie virus(CV)infection and type 1 diabetes mellitus(T1DM).Methods According to the principle of PICOs,the retrieval scheme was constructed,and PubMed,EmBase,Sinomed,CNKI,Wanfang database,and VIP were searched comprehensively with subject words and free words from the inception until May 282020.Newcastle Ottawa scale was used to evaluate the quality of included documents;Revman 5.3 software package was used to draw forest map and funnel map.The odds ratio(or)and 95%confidence interval(CI)were calculated by random effect model(I2>50%)or fixed effect model(I2<50%).The evaluation results included the risk relationship of CV,subtypes(1-6)and type 1 diabetes,and the influence of different study areas,different age and different CV detection methods on the risk relationship of CV and T1DM.Results According to the inclusion and exclusion criteria,372 articles were retrieved.Of them,312 papers that were not related to the research topic were excluded,and 36 papers that were not rigorously designed were excluded after browsing the full text.Finally,24 literature was selected for systematic evaluation and meta-analysis,one of which had no data available.The total sample size was 3163,including 1693 in case group and 1613 in control group.The results showed that the risk of CVB infection in T1DM patients was 5 times higher than that in the control group(OR=4.49,95%CI:2.65-7.50,P<0.05).The risk of CVB infection in T1DM patients was 1.56 times higher than that in the control group(OR=1.56,95%CI:1.20-2.03,P<0.05).The detection method of CVB had a great influence on the results.Conclusion The present evidence suggests that CVB infection has a statistical correlation with T1DM.Therefore,CVB infection may be a cause of T1DM or promote the occurrence of T1DM.

关 键 词：柯萨奇病毒感染 糖尿病 1型 META分析 

分 类 号：R512.5[医药卫生—内科学]