临床荟萃 ›› 2021, Vol. 36 ›› Issue (2): 101-106.doi: 10.3969/j.issn.1004-583X.2021.02.001

• 循证研究 •    下一篇

同型半胱氨酸与妊娠期高血压疾病相关性的meta分析

周艺璇1, 林伟钊2, 李瑞满2()   

  1. 1.暨南大学第一临床医学院,广东 广州 510632
    2.暨南大学附属第一医院 妇产科,广东 广州 510630
  • 收稿日期:2020-07-06 出版日期:2021-02-20 发布日期:2021-02-05
  • 通讯作者: 李瑞满 E-mail:hqyylrm@126.com
  • 基金资助:
    广东省科技计划项目——数字分娩医疗器械的研发与产业化(2015B020233010)

Relationship between homocysteine and hypertensive disorder complicating pregnancy: a meta-analysis

Zhou Yixuan1, Lin Weizhao2, Li Ruiman2()   

  1. 1. The First Clinical Medical College of Jinan University, Guangzhou 510632, China
    2. Department of Obstetrics and Gynecology, the First Affiliated Hospital of Jinan University, Guangzhou 510630, China
  • Received:2020-07-06 Online:2021-02-20 Published:2021-02-05
  • Contact: Li Ruiman E-mail:hqyylrm@126.com

摘要:

目的 系统分析血浆同型半胱氨酸(Hcy)水平与妊娠期高血压疾病(HDCP)患病风险之间的相关性。方法 数据采用 PubMed、EMbase、Cochrane Library、Medline、Web of Science 和中国知网、维普、万方数据库,按纳入与排除标准筛选文献,以Newcastle-Ottawa Scale评价表对文献进行质量评价,应用Rev Man 5.3软件进行meta分析,对纳入的研究进行异质性检验后,选择相应的效应模型合并分析血浆Hcy水平与HDCP患病风险之间的相关性。结果 纳入文献 12 篇,均为高质量文献(评分均>5 分),总样本量10 079例。(1)血浆 Hcy 水平升高与 HDCP 患病风险有关(MD=4.44,95%CI:3.01~5.87,P<0.01)。(2)重度子痫前期孕妇血浆 Hcy 浓度高于轻度子痫前期孕妇(MD=-2.84,95%CI:-3.78~-1.90,P<0.01)。(3)血清叶酸和HDCP相关(MD=-3.21,95%CI:-4.50~-1.91,P<0.01)。(4)血清Vit B12水平和HDCP相关(MD=-65.92,95%CI:-98.57~-33.28,P<0.01)。结论 血浆 Hcy 水平与 HDCP 的发病密切相关, 其浓度与血清中叶酸及维生素 B12(Vit B12) 水平呈负相关性,Hcy 表达水平与子痫前期(PE)严重程度存在明显的关联,提示 Hcy 水平可能为判断PE疗效及预后的监测指标。

关键词: 同型半胱氨酸, 高血压, 妊娠性, 叶酸, 维生素B12, meta 分析

Abstract:

Objective To evaluate the correlation between plasma homocysteine (Hcy) levels and the risk of hypertensive disorder complicating pregnancy (HDCP). Methods PubMed, EMbase, Cochrane Library, Medline, Web of Science, CNKI, VIP and Wanfang data were searched for the literature which met inclusion and exclusion criteria. The quality evaluation of literature was carried out by Newcastle-Ottawa Scale. Rev Man 5.3 software was used to conduct meta-analysis. The included studies were analyzed to explore the correlation between plasma Hcy levels and risk of HDCP by the combination of the heterogeneity inspection and corresponding effect model. Results A total of 12 literature were included, all of which were of high quality (average score >5), with a total sample size of 10 079 cases. (1) The increase of plasma Hcy level was associated with the risk of HDCP(MD=4.44,95%CI: 3.01-5.87, P<0.01). (2)The plasma Hcy concentration in women with severe preeclampsia was higher than that in women with mild preeclampsia(MD=-2.84,95%CI:-3.78 - -1.90, P<0.01). (3) The correlation between serum folic acid and HDCP was statistically significant (MD=-3.21,95%CI:-4.50 - -1.91,P<0.01). (4) The correlation between serum Vit B12 level and HDCP was statistically significant (MD=-65.92,95%CI:-98.57 - -33.28, P<0.01). Conclusion Plasma Hcy level is closely related to the incidence of HDCP, its concentration is negatively correlated with serum levels of folic acid and Vit B12, and its expression level is significantly correlated with the severity of preeclampsia (PE). It is suggested that Hcy level may be a monitoring indicator for the efficacy and prognosis of PE.P

Key words: homocysteine, hypertension, pregnancy-induced, folic acid, Vit B12, meta-analysis

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