本文關(guān)鍵詞： 同型半胱氨酸 慢性心力衰竭 心臟射血分?jǐn)?shù) Meta分析　出處：《吉林大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:本文通過Meta分析的方法,系統(tǒng)評價血清同型半胱氨酸(Homocysteine,HCY)水平與慢性心力衰竭(Chronic heart failure,CHF)的相關(guān)性,探討HCY對慢性心力衰竭的預(yù)測價值,為臨床提供循證醫(yī)學(xué)證據(jù)。方法:將“同型半胱氨酸/Homocysteine、慢性心力衰竭/Chronic heart failure”做為檢索主題詞,再查找相對應(yīng)的自由詞構(gòu)建檢索表達式,對Pubmed、Medline、Embase、The Cochrane library、Web of Science、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫(CBM)、相關(guān)期刊論文(CNKI)、維普數(shù)據(jù)庫(VIP)、萬方(WANFANG)等數(shù)據(jù)庫逐一進行檢索。檢索文獻無語言限制,檢索時間均為自數(shù)據(jù)庫建立起至2017年3月31日為止。文獻篩選的過程由兩名研究人員獨立完成,應(yīng)用Rev Man5.3軟件對各統(tǒng)計量進行統(tǒng)計學(xué)分析。結(jié)果:本次Meta分析共檢索到607篇文獻,最終納入文獻7篇,共納入1037例心衰患者。首先,在未排除其他干擾因素的前提下,針對HCY進行單因素統(tǒng)計分析,異質(zhì)性分析顯示,P0.00001,I2=99%,說明各研究之間異質(zhì)性顯著,故采用隨機效應(yīng)模型,結(jié)果顯示【合并效應(yīng)量WMD=5.43,95%CI(3.09,7.76),P0.00001】,Z=4.56,且P0.00001,說明該研究結(jié)果有統(tǒng)計學(xué)意義,即血清HCY升高是慢性心力衰竭發(fā)生和發(fā)展的獨立危險因素,對于慢性心力衰竭的診斷具有很大價值。隨后,我們又將射血分?jǐn)?shù)(ejection fraction,EF)小于40%納入試驗組的統(tǒng)計變量中,進行多因素統(tǒng)計分析,共納入6篇文獻,其中試驗組703人,對照組2808人。異質(zhì)性分析顯示,I2=9 8%,P0.00001,說明各研究之間異質(zhì)性顯著,依然采用隨機效應(yīng)模型,結(jié)果顯示【合并效應(yīng)量WMD=4.77,95%CI(1.75,7.79),P=0.002】,Z=3.09,且P0.01,說明該研究結(jié)果有統(tǒng)計學(xué)意義,即血清HCY升高是慢性心力衰竭發(fā)生和發(fā)展的獨立危險因素,且血清HCY水平與心臟射血分?jǐn)?shù)呈負(fù)相關(guān)性。結(jié)論:1、血清同型半胱氨酸水平升高是慢性心力衰竭發(fā)生和發(fā)展的獨立危險因素,對于慢性心力衰竭的診斷、治療具有很大價值。2、血清同型半胱氨酸水平與心臟射血分?jǐn)?shù)呈負(fù)相關(guān)性。
[Abstract]:Objective: to evaluate homocysteine homocysteine in serum by Meta analysis. To explore the predictive value of HCY in chronic heart failure (CHF). Methods: "homocysteine / homocysteine". Chronic heart failure / chronic heart failure "as a search theme word, and then find corresponding free words to construct the search expression, on the Pubmed." Medline Embase the Cochrane libraryweb of Science, Chinese Biomedical Literature Database (CBM). The full text databases of Chinese periodicals, such as CNKI, Weip, WANFANGand etc, are searched one by one. There are no language restrictions on the retrieval of literature. The retrieval time was from the establishment of the database to March 31st 2017. The process of literature screening was completed by two researchers independently. Results: a total of 607 articles were retrieved in this Meta analysis, and 7 papers were included. A total of 1 037 patients with heart failure were included. First of all, without excluding other interference factors, univariate statistical analysis of HCY was carried out. Heterogeneity analysis showed that P0.00001 + I2P was 99%. The results of random effect model show that the combined effect quantity WMD5.439 / 95CII 3.09 / 7.76 / P0.00001). ZG 4.56, and P0.00001, show that the results of this study are statistically significant, that is, elevated serum HCY is an independent risk factor for the occurrence and development of chronic heart failure. This is of great value for the diagnosis of chronic heart failure. Subsequently, we included a fraction of ejection fraction (EF) less than 40% in the statistical variables of the trial group. A multivariate statistical analysis was carried out, including 703 subjects in the experimental group and 2808 in the control group. Heterogeneity analysis showed that there was no significant difference between the two groups (P 0.00001). The results showed that there was significant heterogeneity among the various studies, and the random effect model was still used. The results showed that [the combined effect quantity WMD4.77 / 95CII 1.75 / 7.79 / P0. 002]. ZH3. 09 and P0. 01 indicate that the results of this study are statistically significant, that is, elevated serum HCY is an independent risk factor for the occurrence and development of chronic heart failure. Conclusion the elevated serum homocysteine level is an independent risk factor for the occurrence and development of chronic heart failure. The serum homocysteine level was negatively correlated with cardiac ejection fraction.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.6

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