肝硬化伴肝性脑病与血清IL-6表达水平相关性的meta分析

目的　评价肝硬化伴肝性脑病（ hepatic encephalopathy，HE）与血清白细胞介素 -6（serum interleukin-6， sIL-6）水平表达的关系。方法　计算机检索中国生物医学文献（ CBM）、知网（ CNKI）、维普 (VIP)、万方 (WAN FANG)，PubMed，Embase，Web of Science和 Cochrane Library数据库，搜集肝硬化患者中关于 sIL-6水平与 HE相关的病例对照研究，检索时间均为建库至 2021年 4月。根据纳入和排除标准，最终纳入 13个研究，包括 1 479例研究对象，采用 Review Manager Version 5.3进行 meta分析。结果　sIL-6的含量在肝硬化伴 HE组与肝硬化无 HE组比较 SMD=1.29,95%CI（0.51，2.08），P=0.001]，肝硬化伴显性肝性脑病（ overt hepatic encephalopathy，OHE）组与肝硬化无 HE组比较 SMD=2.77,95%CI(1.64，3.89），P＜ 0.000 01]，肝硬化伴轻微肝性脑病（ minimal hepatic encephalopathy, MHE）组与肝硬化无 HE组比较 SMD=2.82,95%CI（1.05，4.58），P=0.002]，肝硬化伴 OHE与肝硬化伴 MHE组比较 SMD=1.82,95%CI(1.30，2.33），P＜ 0.000 01]，肝硬化伴Ⅲ～Ⅳ级 HE组与肝硬化伴Ⅰ～Ⅱ级 HE组比较 SMD=0.95,95%CI(0.52，1.37），P＜ 0.000 1]，肝硬化伴 MHE与健康对照组比较 SMD=4.32,95%CI(2.86，5.77）， P＜ 0.000 01]，肝硬化无 HE组与健康对照组比较 SMD=2.23,95%CI（1.34，3.12），P＜ 0.000 01]，差异均有统计学意义。结论　sIL-6的表达水平可能与肝性脑病的发病机制有关，有望成为诊断肝性脑病及判定预后疗效的重要炎症指标，还需要更多高质量、多中心的研究验证。

Meta Analysis of the Correlation between Serum Interleukin-6 and Hepatic Encephalopathy in Liver Cirrhosis

Objective　To evaluate the relationship between Hepatic encephalopathy (HE) and serum interleukin-6 (sIL-6) in liver cirrhosis. Methods　Computer retrieval of CBM, CNKI, VIP, WanFang, PubMed, Embase, Web of Science and Cochrane Library database were conducted to retrieve case-control studies related to sIL-6 level and HE. The retrieval time was from the establishment of the database to April 2021. According to inclusion and exclusion criteria, 13 studies were included, including 1 479 subjects, and meta-analysis was performed using Review Manager Version 5.3. Results　The levels of sIL-6 were compared between liver cirrhosis with HE group and liver cirrhosis without HE groupSMD=1.29, 95%CI（0.51，2.08）, P=0.001]. Comparison between cirrhosis with OHE group and cirrhosis without HE groupSMD=2.77, 95%CI(1.64，3.89）, P ＜ 0.000 01]. Comparison of cirrhosis with MHE group and cirrhosis without HE groupSMD=2.82, 95%CI（1.05，4.58）, P=0.002]. Cirrhosis with OHE group and cirrhosis with MHE groupSMD=1.82,95%CI(1.30, 2.33）, P ＜ 0.000 01]. Comparison of cirrhosis with grade Ⅲ～Ⅳ HE group and cirrhosis with grade Ⅰ～Ⅱ HE groupSMD=0.95,95%CI(0.52，1.37）, P ＜ 0.000 1]. Comparison of cirrhosis with MHE group and Healthy control groupSMD=4.32, 95%CI(2.86，5.77）, P ＜ 0.000 01]. Comparison of liver cirrhosis without HE group and healthy control groupSMD=2.23, 95%CI（1.34，3.12）, P ＜ 0.000 01], the differences among the above groups were statistically significant. Conclusion　The increase of sIL-6 may be related to the pathogenesis of hepatic encephalopathy. It is expected to be an important inflammatory indicator for diagnosing hepatic encephalopathy and determining its prognosis. However, more high-quality and multi-center studies are needed to verify the level of sIL-6.