脂蛋白相关性磷脂酶A2水平与不同类型冠心病关系的Meta分析

摘要

Objective The relationship between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and different types of coronary heart disease (CHD) was studied.Methods Literatures concerning CHD and Lp-PLA2 published from January 2004 to December 2013 in "Wan fang"," CNKI",PubMed and Science Citation Index Expanded (SCIE)/Social Sciences Citation Index (SSCI)/Arts and Humanities Citation Index (A&HCI) database were retrievaled,and then relevant data were extracted.RevMan5.1 statistical software was used for processing and analysis.Results A total of 8 literatures involving 1 292 subjects were included.Meta-analysis showed that the levels of serum Lp-PLA2 in the patients with stable angina (SA),unstable angina (UA) or acute myocardial infarction (AMI) were significantly higher than those of normal controls,respectively [SMD (95 ％ CI) were 2.46 (1.20,3.71),2.68 (1.47,3.89),and 2.57 (1.50,3.65),all P =0.000].Serum Lp-PLA2 level in patients with UA or AMI was higher than that in patients with SA,respectively [SMD =0.78,95 ％ CI(0.28,1.28),P =0.002],[SMD =1.12,95 ％ CI(0.72,1.51),P =0.000] ;Serum level of Lp-PLA2 in patients with AMI was also higher than that in patients with UA [SMD =0.58,95％ CI (0.29,0.86),P =0.000].Conclusion The study demonstrated that increased serum Lp-PLA2 level is significantly associated with the severity of CHD.%目的 综合评价脂蛋白相关性磷脂酶A2(Lp-PLA2)水平与不同类型冠心病的关系.方法 检索《万方数据库》、《中国知网》、医学文献检索(PubMed)和科学引文索引扩展版(SCIE)/社会科学引文索引(SSCI)/艺术与人文科学引文索引(A&HCI)数据库中2004年1月至2013年12月发表的关于脂蛋白相关性磷脂酶A2与冠心病关系的病例对照研究文献,提取相关数据并应用Stata10.0统计学软件进行处理和分析,研究间的同质性检验采用Q检验,并用I2定量地表示研究间的不一致程度.结果 共纳入8项研究,包括1 292例研究对象.Meta分析结果显示,稳定性心绞痛(SA)组、不稳定性冠心病(UA)组和急性心肌梗死(AMI)组患者的血清Lp-PLA2水平均明显高于正常对照者,差异有统计学意义[标准化均数差(SMD) (95％ CI)分别为2.46(1.20,3.71),2.68(1.47,3.89),2.57(1.50,3.65),P均=0.000].UA和AMI组患者的血清Lp-PLA2水平均高于SA组[标准化均数差(SMD)分别为0.78和1.12,95％ CI分别为(0.28,1.28)和(0.72,1.51),P分别为0.002和0.000];AMI组患者的血清Lp-PLA2水平也比UA组患者高,差异有统计学意义[SMD=0.58,95％ CI(0.29,0.86),P=0.000].结论 血清Lp-PLA2的水平与冠心病有密切的联系,Lp-PLA2的水平随冠心病的严重程度而升高.