内皮型一氧化氮合酶基因G894T多态性与心肌梗死相关性的Meta分析

目的 采用Meta分析的方法评估内皮型一氧化氮合酶（eNOS）基因G894T多态性与心肌梗死（MI）相关性.方法 按照文献纳入标准制定检索策略后,采用计算机检索PubMed、中国期刊全文数据库和万方数据库中1995年至2012年12月30日间发表的探讨eNOS基因G894T多态性与MI相关性的病例-对照研究,由两名作者独立提取数据及评价方法学质量后,采用RevMan 5.1软件进行Meta分析.结果 最终纳入13个病例-对照研究,共计2264例MI患者,2774例健康对照人群.基于随机效应模型的Meta分析结果显示,eNOS G894T多态性能够显著增加MI的患病风险[T vs.G：OR=1.51,95%CI：1.21～1.89;TT vs.GG：OR=1.99,95%CI：1.21～3.26;GT vs.GG：OR=1.34,95%CI：1.07～1.68;（GT＋TT） vs.GG：OR=1.47,95%CI：1.14～1.88;TT vs.（GG＋GT）：OR=1.80,95%CI：1.13～2.86].亚组分析结果表明这一相关性存在于亚洲人群与急性心肌梗死（AMI）之间,而与非亚洲人群无相关性,与混合MI（AMI和陈旧性MI）间可能存在相关性,漏斗图提示有发表偏倚存在.结论 基于当前的证据,eNOS G894T多态性与MI存在相关性,特别是亚洲人群与AMI.但当前证据尚不能确定eNOS G894T多态性是否是MI的独立危险因素,以及eNOS G894T多态性与陈旧性MI、与非亚洲人群AMI的相关性.

A Meta-analysis on correlation between polymorphism of endothelial nitric oxide synthase gene G894T and myocardial infarction

Objective To review the correlation between polymorphism of endothelial nitric oxide synthase （ eNOS ） gene G894T and myocardial infarction （ MI ） by applying Meta-analysis method. Methods The databases of PubMed, CJFD and WangFang Database were retrieved with computers for collecting case- control studies about the correlation between polymorphism of eNOS gene G894T and MI published from 1995 to Dec. 30, 2012 after establishing retrieving strategy according to inclusion and exclusion criterions. The data was extracted and given methodological quality evaluation by two researchers independently, and then given Meta- analysis by using RevMan 5.0 software. Results There were totally 13 case-control studies included involving 2264 cases of MI and 2774 healthy control cases. The results of Meta-analysis based on random-effect model showed that the polymorphism of eNOS gene G894T increased significantly the risk of MI [T vs. G： OR=1.51, 95%CI： 1.21-1.89; TT vs. GG： OR=1.99, 95%CI： 1.21-3.26; GT vs. GG： OR=1.34, 95%CI： 1.07-1.68; （ GT＋TT ） vs. GG： OR=1.47, 95%CI： 1.14-1.88; TT vs. （ GG＋GT ） ： OR=1.80, 95%CI： 1.13-2.86]. The results of subgroup analysis showed that there was the correlation between polymorphism of eNOS gene G894T and acute MI （ AMI ） in Asian population and there was no in non-Asian population. There might be correlation between polymorphism of eNOS gene G894T and mixed MI （ AMI and old MI ） . Funnel plot indicated that there was publication bias. Conclusion Based on current evidences, the polymorphism of eNOS gene G894T is correlated to MI, especially to AMI in Asian population. However, current evidences cannot determine that the polymorphism of eNOS gene G894T is an independent risk factor of MI and correlated to old MI and AMI in non-Asian population.