CAJ | 학술논문

目的：采用 Meta 分析的方法综合评价中国儿童 HLA－DQA1基因多态性与幽门螺杆菌（ Hp）感染的关联性。方法以“幽门螺杆菌”“HLA－DQA1”“基因多态性”“儿童”为检索词，从中国生物医学文献数据库（ CBMdisc）、清华同方（ CNKI）系列数据库、维普数据库（ VIP）、万方数据库、Pubmed和Medline数据库，全面检索1995年1月至2015年1月国内外正式刊物上公开发表的有关HLA－DQA1与中国儿童Hp感染的病例对照研究的文献，应用RevMan 5.0软件对符合筛选标准的研究以OR值作为效应指标，根据异质性检验结果选择相应模型进行综合定量分析。结果符合纳入标准的共11项病例对照研究，共计 Hp感染组445例和正常对照组317例。对11项研究中涉及较多的HLA－DQA1*0101，0102，0103，0104，0201，0301，0302，0401，0501，0601共10个位点进行了Meta分析。经综合分析：①HLA－DQA1*0103和HLA－DQA1*0301可能为中国儿童 Hp感染的易患性基因OR合并及其95％CI 分别为1.77（1.18，2.64），P ＝0.005；1.80（1.09，2.98），P ＝0.02；②HLA－DQA1*0104和HLA－DQA1*0302位点存在异质性，按民族进行亚组分析，结果为：对于HLA－DQA1*0104，HLA－DQA1*0302位点汉族组间无异质性，而少数民族组仍有异质性，亚组结果显示，HLA－DQA1*0302可能是我国汉族儿童的保护基因[OR合并及其95％CI为0.50（0.26，0.98），P＝0.040]；HLA－DQA1*0104可能是少数民族儿童感染易患基因[OR合并及其95％CI为2.15（2.13，3.77），P＝0.007]；③换用模型对其进行敏感性分析显示，除 HLA－DQA1*0104和 HLA－DQA1*0301两位点结论发生改变外，其余位点结论均未发生变化。而剔除小样本后进行敏感性分析显示结论均未发生改变。敏感性分析结果表明结果较可靠。结论中国儿童Hp感染可能与HLA－DQA1*0103和 HLA－DQA1*0301位点有关联，未发现其余位点与感染有关。目的：採用 Meta 分析的方法綜閤評價中國兒童 HLA－DQA1基因多態性與幽門螺桿菌（ Hp）感染的關聯性。方法以“幽門螺桿菌”“HLA－DQA1”“基因多態性”“兒童”為檢索詞，從中國生物醫學文獻數據庫（ CBMdisc）、清華同方（ CNKI）繫列數據庫、維普數據庫（ VIP）、萬方數據庫、Pubmed和Medline數據庫，全麵檢索1995年1月至2015年1月國內外正式刊物上公開髮錶的有關HLA－DQA1與中國兒童Hp感染的病例對照研究的文獻，應用RevMan 5.0軟件對符閤篩選標準的研究以OR值作為效應指標，根據異質性檢驗結果選擇相應模型進行綜閤定量分析。結果符閤納入標準的共11項病例對照研究，共計 Hp感染組445例和正常對照組317例。對11項研究中涉及較多的HLA－DQA1*0101，0102，0103，0104，0201，0301，0302，0401，0501，0601共10箇位點進行瞭Meta分析。經綜閤分析：①HLA－DQA1*0103和HLA－DQA1*0301可能為中國兒童 Hp感染的易患性基因OR閤併及其95％CI 分彆為1.77（1.18，2.64），P ＝0.005；1.80（1.09，2.98），P ＝0.02；②HLA－DQA1*0104和HLA－DQA1*0302位點存在異質性，按民族進行亞組分析，結果為：對于HLA－DQA1*0104，HLA－DQA1*0302位點漢族組間無異質性，而少數民族組仍有異質性，亞組結果顯示，HLA－DQA1*0302可能是我國漢族兒童的保護基因[OR閤併及其95％CI為0.50（0.26，0.98），P＝0.040]；HLA－DQA1*0104可能是少數民族兒童感染易患基因[OR閤併及其95％CI為2.15（2.13，3.77），P＝0.007]；③換用模型對其進行敏感性分析顯示，除 HLA－DQA1*0104和 HLA－DQA1*0301兩位點結論髮生改變外，其餘位點結論均未髮生變化。而剔除小樣本後進行敏感性分析顯示結論均未髮生改變。敏感性分析結果錶明結果較可靠。結論中國兒童Hp感染可能與HLA－DQA1*0103和 HLA－DQA1*0301位點有關聯，未髮現其餘位點與感染有關。
목적：채용 Meta 분석적방법종합평개중국인동 HLA－DQA1기인다태성여유문라간균（ Hp）감염적관련성。방법이“유문라간균”“HLA－DQA1”“기인다태성”“인동”위검색사，종중국생물의학문헌수거고（ CBMdisc）、청화동방（ CNKI）계렬수거고、유보수거고（ VIP）、만방수거고、Pubmed화Medline수거고，전면검색1995년1월지2015년1월국내외정식간물상공개발표적유관HLA－DQA1여중국인동Hp감염적병례대조연구적문헌，응용RevMan 5.0연건대부합사선표준적연구이OR치작위효응지표，근거이질성검험결과선택상응모형진행종합정량분석。결과부합납입표준적공11항병례대조연구，공계 Hp감염조445례화정상대조조317례。대11항연구중섭급교다적HLA－DQA1*0101，0102，0103，0104，0201，0301，0302，0401，0501，0601공10개위점진행료Meta분석。경종합분석：①HLA－DQA1*0103화HLA－DQA1*0301가능위중국인동 Hp감염적역환성기인OR합병급기95％CI 분별위1.77（1.18，2.64），P ＝0.005；1.80（1.09，2.98），P ＝0.02；②HLA－DQA1*0104화HLA－DQA1*0302위점존재이질성，안민족진행아조분석，결과위：대우HLA－DQA1*0104，HLA－DQA1*0302위점한족조간무이질성，이소수민족조잉유이질성，아조결과현시，HLA－DQA1*0302가능시아국한족인동적보호기인[OR합병급기95％CI위0.50（0.26，0.98），P＝0.040]；HLA－DQA1*0104가능시소수민족인동감염역환기인[OR합병급기95％CI위2.15（2.13，3.77），P＝0.007]；③환용모형대기진행민감성분석현시，제 HLA－DQA1*0104화 HLA－DQA1*0301량위점결론발생개변외，기여위점결론균미발생변화。이척제소양본후진행민감성분석현시결론균미발생개변。민감성분석결과표명결과교가고。결론중국인동Hp감염가능여HLA－DQA1*0103화 HLA－DQA1*0301위점유관련，미발현기여위점여감염유관。
Objective To assess the associations of HLA-DQA1 gene polymorphism with Helicobacter pylori( Hp) infection in Chinese children through meta-analysis.Methods Articles published from 1995 to 2015 on the relationship between HLA-DQA1 gene polymorphism and Helicobacter pylori infection were searched from CBMdisc,CNKI database,VIP database,Wanfang database,Pubmed and Medline,using the searching terms of “Helicobacter pylori”“HLA-DQA1”“gene polymorphism”“children”,etc.The results were quantitatively analyzed by RevMan 5.0 software,the pooled odds ratio( OR) were calculated by choo-sing fixed effect model or random effect mode,according to the result of Heterogeneity test.Results A total of 445 children with Helicobacter pylori infection and 317 uninfected healthy controls were included from 11 studies.Meta-analysis were conducted in the following gene loci:HLA-DQA1*0101,0102,0103,0104,0201, 0301,0302,0401,0501,0601.After comprehensive analysis:①HLA-DQA1 *0103 and HLA-DQA1*0301 alleles were the risk factors of Hp infection,the values of pooled odds ratio were 1.77(95%CI 1.18-2.64, P=0.005)and 1.80(95%CI 1.09-2.98,P =0.02)respectively.②Subgroup-analysis:the results of sub-group analyses based on nationality showed:for HLA-DQA1*0104 and HLA-DQA1*0302 no heterogeneity was observed in Han nationality group,but not in minority group as to HLA-DQA1*0302.In addition,statis-tical difference was found after subgroup analyses in the Han nationality group .HLA-DQA1*0302 alleles were the protection factors against Hp infection,and the values of pooled odds ratio were 0.50(95%CI 0.26-0.98,P=0.04).HLA-DQA1*0104 alleles were the susceptible factors against helicobacter pylori infection in the minorities,and the values of pooled odds ratio were 2.15(95%CI 2.13-3.77,P=0.007).③Sensitiv-ity analysis:almost all the conclusions were not changed except for the DQA1*0104 and DQA1*0301 when changing statistical model,while sensitivity analysis did not change the conclusions after removing the small sample,showing that the results were reliable.Conclusion The occurrence of Hp infection is associated with the gene polymorphism of HLA-DQA1*0103,*0301 in Chinese children,while no correlations with other loci are observed.