X染色体失活偏移与反复自然流产关系的meta分析  

Investigation of the correlation between the skewed X-chromosome inactivation of women and their recurrent spontaneous abortion:a meta-analysis

作　　者：王璐 杨梦怡 赵璐璐 霍正浩[2] 王永军 WANG Lu;YANG Mengyi;ZHAO Lulu;HUO Zhenghao;WANG Yongjun(Beijing Jishuitan Hospital,Capital Medical University,Beijing,100096;Key Laboratory of Fertility Pres-ervation and Maintenance of Ministry of Education,Ningxia Medical University)

机构地区：[1]首都医科大学附属北京积水潭医院,100096 [2]宁夏医科大学教育部,生育力保持省部共建重点实验室

出　　处：《中国计划生育学杂志》2024年第4期730-737,共8页Chinese Journal of Family Planning

摘　　要：目的:探讨X染色体失活偏移(SXCI)与反复自然流产(RSA)之间的关系。方法:计算机检索PubMed、Medline、Cochraene、CNKI、CBM及万方等数据库,搜集自建库至2023年6月有关SXCI与RSA关系的病例-对照研究文献。采用RevMan 5.3和Stata 16.0软件对严格筛选后纳入的15项研究中3706例女性(病例组1673例,对照组2033例)相关数据进行meta分析。结果:总体分析中,病例组SXCI比例显著高于对照组(OR=1.68,95%CI 1.29~2.18);不同程度分层分析中,中度SXCI比例在病例组和对照组间的差异无统计学意义(OR=1.11,95%CI 0.56~2.18),高度(OR=2.32,95%CI 1.31~4.11)和极端(OR=4.71,95%CI 1.77~12.52)SXCI比例在病例组均显著增高;不同流产次数分层分析中,流产≥2次(OR=5.06,95%CI 2.46~10.40)和流产≥3次(OR=2.48,95%CI 1.66~3.68)时,病例组高度和极端SXCI比例均显著高于对照组。结论:SXCI,尤其是高度和极端SXCI与RSA的发生风险增大显著关联,且流产次数越多,这种关联性可能越明显。Objective:To investigate the correlation between the skewed X-chromosome inactivation(SXCI)of women and their recurrent spontaneous abortion(RSA).Methods:The databases,such as PubMed,Medline,Cochrane,CNKI,CBMand Wanfang,were searched by computer from the established database until June,2023 to collect the case-control studies about the correlation between SXCI of the women and their RSA.A meta-analysis was performed on the related-data of 3,706 women(1,673 women in case group and 2033 women in control group)from 15 studies that were included after strict screening by Revman 5.3 and Stata 16.0 software.Results:In the overall analysis,the proportion of SXCI of the women in the case group was significantly higher than that of the women in the control group(OR=1.68,95%CI=1.29-2.18,P<0.000).In the stratified analysis of the different degrees of SXCI,there was no statistical significance difference in the proportion of the moderateSXCI of the women between the two groups(OR=1.11,95%CI=0.56-2.18,P=0.760),while the proportions of the highSXCI(OR=2.32,95%CI=1.31-4.11,P=0.004)and the extreme SXCI(OR=4.71,95%CI=1.77-12.52,P=0.002)of the women in the case group were significantly higher than those of the women in the control group.In the stratified analysis of the women with different abortion numbers,the number of the miscarriages≥2 times(OR=5.06,95%CI=2.46-10.40,P<0.000)and the number of the miscarriages≥3 times(OR=2.48,95%CI=1.66-3.68,P<0.000)of the women in the case group had significantly higher proportions of the high SXCI and the extreme SXCI compared with those of the women in the control group.Conclusion:The SXCI,especially the high SXCI or the extreme SXCI,of the women was significantly associated with the increased risk of their RSA,and the more number of the miscarriages of the women,the greater association is likely to be.

关 键 词：反复自然流产 X染色体失活偏移 META分析 

分 类 号：R714.21[医药卫生—妇产科学]