【摘要】 目的　采用汇总 (meta)分析的方法确定巨细胞病毒 (CMV)感染是否为冠心病的危险因素。方法　全面收集国内外发表的有关CMV感染与冠心病关系的血清流行病学研究资料 ,利用RevMan软件进行固定效应模型和随机效应模型的meta分析。对不同纳入标准的结果进行了敏感性分析。用漏斗图分析发表性偏倚。结果　对收集的全部文献、国内研究资料、国外研究资料分别进行meta分析 ,其比值比 (OR) (95 %可信区间 )分别为 2 0 5 (1 6 2～ 2 5 9)、4 74 (2 78～ 8 0 8)、1 34(1 13～ 1 5 9) ;对采用酶联免疫吸附法、固相放射免疫法、聚合酶链反应法检测CMVIgG抗体的研究资料分别进行meta分析 ,其OR(95 %可信区间 )分别为 1 4 5 (1 15～ 1 82 )、1 84 (1 2 0～ 2 83)、5 75(4 4 2～ 7 83) ;敏感性分析结果提示不同纳入标准的研究资料的meta分析结果一致。漏斗图分析提示存在发表性偏倚。结论　冠心病患者存在CMV感染 ,CMV感染与冠心病之间存在弱关联。更多还原

【Abstract】 Objective To determine whether coronary heart disease(CHD) is associated with cytomegalovirus (CMV) infections. Methods Seroepidemiologic studies published before 2002 in any language that reported on correlations between CHD and the presence of CMV were selected by computer-assisted searches in MEDLINE, CBMdisc,ISTP, SCI, EMBASE, etc. Combinations of key words were used in the computer searches, including cytomegalovirus, cytomegalovirus infection, coronary heart disease or coronary disease. Meta-analysis was used to systematic review. Heterogeneity was assessed with standard chi-square tests. Funnel plot was made to confirm publication bias. Results Thirty-three trials were selected to include in this review. The relationship between CHD and CMV were analyzed by means of random effect model of meta-analysis. The totally involved subjects were 9004, among them 4388 were patients. The pooled odds ratio (OR) of 33 studies was 2.05, 95% confidence interval (CI) was 1.62～2.59. The pooled ORs(95%CIs) for foreign language studies and Chinese studies were 4.74(2.78～8.08) and 1.34(1.13～1.59) respectively. The pooled ORs(95%CIs) for trials measured by enzyme-linked immunosorbent assay (ELISA), solid-phase radioimmunography and polymerase chain reaction (PCR) were 1.45(1.15～1.82), 1.84(1.20～2.83) and 5.72(2.14～7.91) respectively. Meta-analysis showed that CHD was associated with CMV infection. Sensitive analysis confirmed this finding. There was publication bias in 33 included studies. Conclusion CMV infection is associated with CHD. There is an infirmness relationship between them.更多还原