在孕前中溶性血栓模块素:系统性审查和元分析
Jesiel Francisco de Jesus Fernandes Martins Lima1, Thaíse Emilia Moreira da Silva1, Ana Cristina Dos Santos Lopes1
1Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil.
概括
在孕前症 (PE) 患者中,可溶性血栓模块素 (sTM) 水平显著更高,特别是在严重的病例中. 这一系统性审查表明,sTM可能表明PE的严重程度,但需要更多的研究来临床使用.
科学领域:
- 产科和妇科 产科和妇科
- 心血管研究研究心血管研究
- 生物标志物发现发现
背景情况:
- 孕前 (PE) 是一种严重的妊娠并发症,与内皮功能障碍有关.
- 溶性血栓模块素 (sTM) 是内皮损伤的生物标志物,但其在PE中的作用尚未完全理解.
- 之前的研究表明,由于不同的方法,PE中sTM水平存在矛盾.
研究的目的:
- 系统地审查和分析关于产前激素水平的观察性研究.
- 为了澄清sTM和PE之间的关联,考虑不同的严重程度组.
- 评估sTM作为PE严重程度的生物标志物的潜力.
主要方法:
- 按照PRISMA和Cochrane指南进行系统审查和随机效应元分析.
- 在 MEDLINE/PubMed,EMBASE 和 Web of Science 搜索了观察性研究 (病例控制,队列).
- 从20项研究 (285项选) 中提取数据,并使用纽卡斯尔-太华尺度评估偏差风险.
主要成果:
- 与正常血压对照组相比,PE患者的sTM水平显著更高 (SMD = 0.91).
- 在严重PE (SMD = 0.86) 中,增加的sTM水平比在轻度PE (SMD = 0.57) 中更明显.
- 在研究中观察到很高的异质性 (I2 = 94%),归因于标准和方法的变化.
结论:
- 在妊娠前中,sTM水平升高,与疾病严重程度相关.
- sTM显示出作为评估PE严重程度的生物标志物的潜力.
- 临床实用性受到方法异质性和缺乏标准化的截止值的限制;需要进一步的前性研究.
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