本文關(guān)鍵詞：特納綜合征與甲狀腺疾病相關(guān)性的Meta分析　出處：《蘭州大學(xué)》2016年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 特納綜合征 甲狀腺疾病 相關(guān)性 發(fā)病率 Meta分析

【摘要】：目的:系統(tǒng)評(píng)價(jià)特納綜合征(TS)與甲狀腺疾病之間的相關(guān)性及特納綜合征患者中甲狀腺疾病的發(fā)病特征,為開(kāi)展甲狀腺疾病監(jiān)測(cè)和隨訪工作提供科學(xué)依據(jù)。方法:計(jì)算機(jī)檢索PubMed(1966~2016.2)、Web of Science(1980~2016.2)、The Cochrane Library(~2016.2)、EMBASE.com(1974~2016.2)、中國(guó)維普期刊資源數(shù)據(jù)庫(kù)VIP.com(1989~2016.2)、中國(guó)萬(wàn)方學(xué)術(shù)數(shù)據(jù)庫(kù)wangfangdata.com(1997~2016.2)、相關(guān)期刊論文CNKI(1994~2016.2)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)CBM(1978~2016.2),并輔以手工檢索會(huì)議論文及追蹤納入研究的參考文獻(xiàn)。2名研究人員依據(jù)已制定的納入排除標(biāo)準(zhǔn),獨(dú)立進(jìn)行研究文獻(xiàn)的篩選、研究資料的提取和研究質(zhì)量的評(píng)價(jià),采用Stata12.0和RevMa5.3軟件進(jìn)行Meta分析合并OR值、發(fā)病率等研究指標(biāo),繪制森林圖和漏斗圖,并進(jìn)行敏感性分析和發(fā)表偏倚分析。結(jié)果:(1)特納綜合征與甲狀腺疾病相關(guān)性的Meta分析結(jié)果:最終納入9篇病例-對(duì)照研究,共計(jì)1705例患者,特納綜合征組(TS組)731例,非特納綜合征組(NS組)974例。Meta分析結(jié)果顯示:①特納綜合征與甲狀腺功能異常之間存在顯著相關(guān)性O(shè)R=15.35(95%CI:8.42,27.97);②特納綜合征與甲狀腺自身抗體(TAA)陽(yáng)性之間存在相關(guān)性O(shè)R=7.16(95%CI:4.70,10.90);③依據(jù)特納綜合征染色體核型進(jìn)行亞組分析,結(jié)果顯示單體核型、等臂核型、其他核型均與甲狀腺自身抗體陽(yáng)性相關(guān)[OR=7.37(95%CI:4.24,12.82);OR=20.48(95%CI:7.21,58.16);OR=7.36(95%CI:3.16,17.13)],表明無(wú)論特納綜合征患者染色體核型如何變化,均與甲狀腺自身抗體陽(yáng)性密切相關(guān)。(2)特納綜合征合并甲狀腺疾病發(fā)病率的Meta分析結(jié)果:最終納入30篇研究,其中病例-對(duì)照研究9篇,病例系列研究21篇,共計(jì)4487例特納綜合征患者。Meta分析結(jié)果顯示:特納綜合征合并甲狀腺功能異常的總發(fā)病率為22%(95%CI:0.18,0.26),特納綜合征合并甲狀腺功能減退的總發(fā)病率為20%(95%CI:0.17,0.24);特納綜合征合并甲狀腺自身抗體陽(yáng)性的總發(fā)病率為37%(95%CI:0.31,0.43)。亞組分析顯示:①國(guó)內(nèi)和國(guó)外特納綜合征合并甲狀腺功能異常的發(fā)病率分別為26%(95%CI:0.18,0.35)和19%(95%CI:0.15,0.22),兩組間有顯著差異(P0.05)。②單體核型、等臂核型、其他核型特納綜合征患者合并甲狀腺自身抗體陽(yáng)性的發(fā)病率分別為40%(95%CI:0.34,0.46)、58%(95%CI:0.43,0.73)和29%(95%CI:0.21,0.370),其中等臂核型TS患者TAA陽(yáng)性的發(fā)病率高于單體核型和其他核型,三種核型間有顯著差異(P0.05);③不同年齡段(≤10歲和10歲)特納綜合征患者TAA陽(yáng)性的發(fā)病率分別為25%(95%CI:0.15,0.35)和40%(95%CI:0.14,0.66),兩年齡段間有顯著差異(P0.05)。結(jié)論:現(xiàn)有證據(jù)表明,特納綜合征與甲狀腺疾病存在相關(guān)性;特納綜合征合并甲狀腺疾病的發(fā)病率較高且隨年齡增加有上升趨勢(shì),在不同地區(qū)、染色體核型間存在差異。
[Abstract]:Objective: to evaluate the relationship between TSX and thyroid diseases and the characteristics of thyroid diseases in patients with Turner syndrome. To provide scientific basis for thyroid disease monitoring and follow-up. Methods: PubMedus 1966 / 2016.2 was searched by computer. Web of Science 1980 / 2006 / 2 / the Cochrane Library. EMBASE.com1974 / 2016 / 2, VIP.com, China's WIP Journal Resource Database, 1989 / 2016.2). Wangfangdata.com1997 and CNKI1994-2016.2China Journal Full-Text Database (CNKI). China Biomedical Literature Database (CBM: 197819 / 2016.2). And assisted by manual retrieval of conference papers and tracking into the study of reference .2 researchers according to the established inclusion exclusion criteria for independent screening of research literature. Research data extraction and research quality evaluation, using Stata12.0 and RevMa5.3 software for Meta analysis combined OR value, morbidity and other research indicators. The sensitivity analysis and publication bias analysis were performed. Results Meta analysis of the association between Turner's syndrome and thyroid disease was carried out. Nine case-control studies were conducted. A total of 1705 patients were included in this study. 731 patients in TS group were treated with Turner syndrome. Meta-analysis of 974 cases of NS in non-Turner syndrome group. The results of meta-analysis showed that there was a significant correlation between Thyroid dysfunction and Thyroid dysfunction (OR15.35) (. 95CI: 8.42. 27.97; (2) there was a correlation between Turner's syndrome and thyroid autoantibody (TAA) positive. 3 according to chromosome karyotype analysis of Turner's syndrome, the results showed that monomeric karyotype, isobaric karyotype and other karyotypes were correlated with thyroid autoantibody positive. [Org 7.37 / 95 CI: 4.24 / 12.82; The order is 20.48 / 95. I am 7.21 and 58.16; The results show that no matter how the chromosome karyotype changes in the patients with Turner's syndrome. The results of Meta analysis on the incidence of Turner syndrome with thyroid disease were as follows: 30 studies were included, 9 of them were case-control studies. Case series 21 studies. Meta-analysis of 4487 patients with Turner syndrome showed that the total incidence of Turner syndrome with thyroid dysfunction was 2295 CI: 0.180.26). The total incidence of Turner syndrome with hypothyroidism was 20% CI: 0.17% 0.24%; The total incidence of Turner syndrome with thyroid autoantibody was 37% CI: 0.31. Subgroup analysis showed that the incidence of Turner's syndrome associated with thyroid dysfunction in China and abroad was 26% and 95%: 0.18, respectively. 0.35) and 19.95% CI: 0.15 / 0.22, there are significant differences between the two groups in P0.052.Monomeric karyotype and isobaric karyotype. The incidence of thyroid autoantibody positive in other karyotypic Turner syndrome patients was 400.95% CI: 0.34 0.46% 0.58% 95 CI: 0.43. The incidence of TAA positive in patients with isobaric karyotype TS was higher than that in monomeric karyotype and other karyotype. There was significant difference among the three karyotypes (P0.05). 3The incidence of TAA positive in patients with Turner syndrome in different age groups (鈮，

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