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视网膜静脉阻塞危险因素的Meta分析
李泽锋
周希瑗
刘丹宁
作者及单位信息
·
DOI： 10.3760/cma.j.issn.2095-0160.2020.03.007
Meta-analysis of retinal vein occlusion risk factors
Li Zefeng
Zhou Xiyuan
Liu Danning
Authors Info & Affiliations
Li Zefeng
Department of Ophthalmology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
Zhou Xiyuan
Liu Danning
·
DOI： 10.3760/cma.j.issn.2095-0160.2020.03.007
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摘要

目的系统评价视网膜静脉阻塞(RVO)的危险因素以对其进行有效的预防和治疗。

方法检索Cochrane图书馆、PubMed数据库、Embase数据库。文献检索起止时间均从建库至2018年12月，收集有关RVO危险因素的研究报道。采用NOS评价方法评价文献质量，提取有效数据后，采用Stata 12.0软件进行Meta分析。

结果共纳入31篇文献，其中病例组4 370例，对照组6 534例。Meta分析结果显示，高血压[优势比(OR)＝3.08，95%置信区间(CI)：2.22～4.28]、糖尿病(OR＝1.61，95% CI：1.11～2.32)、高脂血症(OR＝1.73，95% CI：1.27～2.36)、高水平脂蛋白A(OR＝2.72，95% CI：1.06～6.97)、高同型半胱氨酸血症(OR＝1.86，95% CI：1.47～2.35)、凝血因子V Leiden基因突变(OR＝1.89，95% CI：1.17～3.06)是RVO发病的风险因素，而亚甲基四氢叶酸还原酶基因(MTHFR)C677T突变(OR＝1.41，95% CI：0.93～2.14)、凝血酶原基因G20210A突变(OR＝1.20，95% CI：0.81～1.79)非RVO发病的风险因素。亚组分析显示，高血压及糖尿病因素异质性在年龄≥60岁的人群中，分别从88.9%、75.7%降至59.8%、63.2%，高同型半胱氨酸血症因素异质性在年龄<60岁人群中从85.6%降至64.3%。敏感性分析结果显示，改变分析模型后分析结果无明显改变。所纳入研究的文献间均无发表偏倚。

结论高血压、高脂血症、糖尿病、高水平脂蛋白a、高同型半胱氨酸血症、凝血因子V Leiden基因突变是RVO发生的危险因素。

视网膜静脉阻塞;危险因素;Meta分析
ABSTRACT

ObjectiveTo evaluate the risk factors for retinal vein occlusion(RVO) through a meta-analysis.

MethodsThe literatures on risk factors of RVO were searched in the Cochrane library, PubMed, and Embase databases.The literature search time ranged from the establishment of database to December 2018.The literatures were evaluated and filtrated by using Newcastle-Ottawa Scale, Stata software (version 12.0) was used for data processing.

ResultsA total of 31 case-control studies with 4 370 cases and 6 534 controls were included.The meta-analysis showed that hypertension (odds ratio[OR]=3.08, 95% confidence interval [CI]: 2.22-4.28), diabetes (OR=1.61, 95% CI: 1.11-2.32), hyperlipidemia (OR=1.73, 95% CI: 1.27-2.36), hyperlipoprotein (a)-emia (OR=2.72, 95% CI: 1.06-6.97), hyperhomocysteinemia (OR=1.86, 95% CI: 1.47-2.35), mutation of coagulation factor V Leiden gene (OR=1.89, 95% CI: 1.17-3.06) were risk factors for RVO.However, mutation of gene MTHFR C677T (OR=1.41, 95% CI: 0.93-2.14)、mutation of prothrombin gene G20210A (OR=1.20, 95% CI: 0.81-1.79) were not found to be risk factors for RVO.Subgroup analysis showed that the heterogeneity of hypertension and diabetes among people aged over 60 decreased from 88.9% and 75.7% to 59.8% and 63.2%, respectively.The heterogeneity of hyperhomocysteinemia in people aged below 60 decreased from 85.6% to 64.3%.The sensitivity analysis results showed that there were no significant differences after changing the analysis model.There was no publication bias among the literatures.

ConclusionsHypertension, diabetes, hyperlipidemia, hyperhomocysteinemia, hyperlipoprotein (a)-emia, mutation of coagulation factor V Leiden gene are risk factors for retinal vein occlusion.

Retinal vein occlusion;Risk factors;Meta-analysis
Zhou Xiyuan, Email: mocdef.nabuyila2002nauyixuohz
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引用本文

李泽锋,周希瑗,刘丹宁. 视网膜静脉阻塞危险因素的Meta分析[J]. 中华实验眼科杂志,2020,38(03)：192-199.

DOI:10.3760/cma.j.issn.2095-0160.2020.03.007

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视网膜静脉阻塞(retinal vein occlusion，RVO)是继糖尿病视网膜病变后的第二大常见视网膜血管性疾病，也是常见的致盲眼病之一，主要分为视网膜分支静脉阻塞(branch retinal vein occlusion，BRVO)、视网膜中央静脉阻塞(central retinal vein occlusion，CRVO)。目前，RVO确切的发病机制尚未完全阐明。有研究显示，系统性高血压、血黏度异常、血脂代谢异常等与RVO的发病有关 [ 1 , 2 ]。到目前为止，已有多项研究讨论了RVO发生的危险因素，主要是结合患者的既往健康状况、人口学特征以及RVO发病时的情况来研究影响RVO发病的因素 [ 3 , 4 ]。然而，该类研究结果尚有差异，且异质性较大，需要进一步综合评价。本研究采用Meta分析方法对RVO危险因素的文献报道进行系统评价，探讨多种危险因素与RVO发生的关联性。
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备注信息
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周希瑗，Email： mocdef.nabuyila2002nauyixuohz
B
所有作者均声明不存在利益冲突
C
重庆市科卫联合医学科研项目 (2018ZDXM017)
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