【摘要】 目的运用荟萃分析方法综合评价肿瘤坏死因子α基因启动子308位(TNF-α-308)G/A 基因型与慢性阻塞性肺疾病(COPD)的相关性。方法检索 Medline 和中国生物医学光盘数据库,获取 TNF-α-308基因多态性与 COPD 易感性的病例-对照研究,使用统一的表格提取资料,应用RevMan 4.2软件进行统计学处理。结果检索的17篇文献中有18个病例-对照研究,共有1606例COPD 患者(亚洲人666例,白种人940例)和2551例对照(亚洲人898例,白种人1653例)被纳入荟萃分析。亚洲人群等位基因 TNF2与 COPD 密切相关(OR=2.62,95%CI 为2.00～3.43),基因型TNF1/2及基因型 TNF1/2合并 TNF2/2者的 COPD 易感性高于基因型 TNFl/1者(OR=2.44,95%CI为1.79～3.33及 OR=2.78,95%CI 为2.06～3.75),校正吸烟前后的敏感性结果相似。白种人等位基因 TNF2与 COPD 易感性无相关性(OR=0.97,95%CI 为0.84～1.14),基因型 TNF1/2及基因型TNF1/2合并 TNF2/2者的 COPD 易感性与基因型 TNF1/1者相似(OR=0.96,95%CI 为0.79～1.16及 OR=1.03,95%CI 为0.86～1.25),校正吸烟前后的敏感性结果相似。结论在亚洲人群中 TNF2等位基因是 COPD 的危险因素,在白种人群中 TNF-α-308的 G/A 基因多态性与 COPD 易感性无关。更多还原

【Abstract】 Objective To investigate the association between the polymorphism of tumor necrosis factor alpha 308 gene(TNF-α-308)promoter and the risk of chronic obstructive pulmonary disease(COPD) using the method of recta-analysis.Method The database of Medline and the Chinese biomedicine disc (CBM)were searched for published case-control studies of the association between the polymorphism of TNF-α-308 gene promoter and COPD.Data were extracted using a standardized form and the recta-analysis was performed.Results Eighteen case-control studies,comprising 1606 patients with COPD and 2551 controls(the oriental population:666 patients with COPD and 898 controls;the Caucasian:940 patients with COPD and 1653 controls)were included in the recta-analysis.Using a fixed effect model,the pooled result in the oriental population showed that the TNF2 allele was associated with the susceptibility to COPD [odds ratio(OR)= 2.62,95% confidence interval(95% CI)2.00 to 3.43].The OR for COPD susceptibility in TNF1/2 population was significantly increased at 2.44(95% CI 1.79 to 3.33)compared to the TNF1/1 population.The OR for COPD susceptibility in the TNF1/2 plus TNF2/2 population was significantly increased at 2.78(95% CI 2.06 to 3.75)compared to the TNF1/1 population.When adjusted for smoking,the result was similar.However,in the Caucasian population,the TNF2 allele was not associated with the susceptibility to COPD(OR = 0.97,95% CI 0.84 to 1.14).There was no association between the genotype of TNF-α-308 and COPD(OR = 0.96,95% CI 0.79 to 1.16,and OR = 1.03,95% CI 0.86 to 1.25),compared between the TNF1/2 population,the TNF1/2 plus the TNF2/2 population and the TNF1/1 population respectively.When adjusted for smoking,the result was similar.Conclusion In the oriental population,the TNF2 allele confers a significant risk for developing COPD.There is no association between the polymorphism of TNF-α-308 gene promoter and COPD in the Caucasian population.更多还原