腫瘤坏死因子-α-308位点等位基因多态性与我国尘肺病及其严重程度相关性的Meta分析(定稿).doc

肿瘤坏死因子α-308位点等位基因多态性与我国尘肺病及其严重程度相关性的Meta分析 张丽娇，王群，马列，陈东红，王玲玲，王笑歌，张旭华 中国医科大学附属第四医院 呼吸内科，辽宁沈阳，110032 摘要 目的 从循证医学的角度综合分析肿瘤坏死因子α（TNF-α）-308位点等位基因多态性与尘肺病发病及其严重程度的相关性。方法 采用Meta分析系统评估方法，综合分析我国1979~2010年累计涉及2388例的8篇关于TNF-α-308位点等位基因多态性与尘肺病及其严重程度相关性的文献研究。结果 共纳入8个研究（2005~2009），其中病例组1005例，对照组1383例。尘肺病病例组-308A的分布频率明显高于对照组，[优势比（OR）=1.71，95%可信区间（95％CI）=1.21~2.43，P0.01]。尘肺病Ⅲ期患者-308A的分布频率明显高于Ⅰ期患者，(OR)=2.39，95％CI=1.13~5.04，P0.05。结论 TNF-α-308位点等位基因多态性与尘肺病发病有关。TNF-α-308位点等位基因多态性与尘肺病严重程度有关。 关键词 尘肺；肿瘤坏死因子α；等位基因；Meta分析 中图分类号：R598.2 文献标识码：A Meta-analysis on the influence of Tumor Necrosis Factor-alpha -308 genomic polymorphism on pneumoconiosis and its severity in China. ZHANG Li-jiao ,WANG Qun ,MA Lie ,CHEN Dong-hong ,WANG Ling-ling, WANG Xiao-ge, ZHANG Xu-hua. Department of respiration，The Fourth Affiliated Hospital of China Medical University，Shenyang，110032，China. ABSTRACT: Objective To analyze the influence of tumor necrosis factor-alpha(TNF-α)-308 genomic polymorphism on pneumoconiosis and its severity. Methods Eight documents which involve 2388 cases about the influence of TNF-α-308 genomic polymorphism on pneumoconiosis and its severity during the 31 years in China were analyzed by meta-analysis Results There were 1005 patients and 1383 controls for TNF-α-308 genotype in 8 researches.-308 A gene frequency of patients was obviously higher than controls. The odds ratio(OR) value was 1.71.The 95% Confidence interval (95%CI) was1,21~2.43,(P0.01).While -308 A gene frequency of patients at stage Ⅲ was obviously higher than stage Ⅰ.The OR value was 2.39.95%CI=1.13~5.04,(P0.05). Conclusion TNF-α-308 genomic polymorphism is associated with pneumoconiosis. TNF-α-308 genomic polymorphism is associated with the severity of pneumoconiosis. KEYWORDS: pneumoconiosis; tumor necrosis factor-alpha;alleles;Meta-analysis. 尘肺病是由于在职业活动中长期吸入生产性粉尘，并在肺内潴留而引起的以肺组织弥漫性纤维化为主的全身性疾病[1]。大量研究表明，吸入粉尘后肺泡巨噬细胞活化并释放多种生物活性物质[2,3]，其中很多关于肿瘤坏死因子α（tumor necrosis factor α,TNF-α）的研究显示，煤工尘肺、矽肺、石棉肺等多种尘肺病患者的TNF-α含量明显增加