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Received:March 25, 2019 Published Online:January 20, 2020
Received:March 25, 2019 Published Online:January 20, 2020
中文摘要: 目的 系统评价血尿酸(sUA)在慢性阻塞性肺疾病(COPD)患者中的临床意义。
方法 计算机检索Web of Science、PubMed、Cochrane Library、Ovid、CNKI、CBM、VIP、万方、SpringerLink、Embase、Wiley Online Library等数据库,全面收集sUA与COPD的相关文献,按照Cochrane系统评价手册推荐的方法对纳入研究的文献进行评价,对符合纳入标准的病例对照研究应用RevMan 5.3软件进行Meta分析。
结果 共纳入15个病例对照研究,1 983例［主要为AECOPD（含肺功能分级Ⅰ、Ⅱ、Ⅲ、Ⅳ级），少部分为入组时COPD稳定期或治疗后进入稳定期］患者及782例健康人。Meta分析结果显示:(1)AECOPD组患者sUA高于健康对照组(SMD=2.05,95%CI=1.55~2.55,P<0.01);(2)AECOPD患者治疗前sUA高于治疗后(SMD=1.03,95%CI=0.72~1.34,P<0.01);(3)AECOPD治疗未好转患者治疗前后sUA比较,差异无统计学意义(MD=-11.23,95%CI=-53.63~31.17,P>0.05);(4)AECOPD治疗好转患者治疗后sUA低于治疗前(SMD=1.30,95%CI=0.79~1.80,P<0.01);(5)AECOPD组患者sUA高于COPD稳定期组患者(SMD=2.54,95%CI=0.46~4.62,P<0.05);(6)COPD稳定期组患者sUA高于健康对照组(SMD=0.82,95%CI=0.39~1.25,P<0.01);(7)从COPD Ⅰ级到Ⅳ级患者,sUA水平呈逐级升高趋势,差异均有统计学意义 (P<0.01)。
结论 随着COPD 患者病情的加重,尤其在急性加重期时,sUA水平逐渐升高,可以作为判断COPD患者病情严重程度、病情急缓以及评估治疗效果的重要指标。
Abstract:Objective To systematically evaluate the clinical significance of serum uric acid (sUA) in patients with stable chronic obstructive pulmonary disease (COPD).
Methods The databases such as Web of Science,PubMed,Cochrane Library,Ovid,CNKI,CBM,VIP,Wanfang,SpringerLink,Embase and Wiley Online Library were searched,and the relevant literature of sUA and COPD was comprehensively collected.According to the method recommended by Cochrane system evaluation manual,the literature in the study was evaluated,and the case-controll study meeting the inclusion criteria were meta analyzed with RevMan 5.3.
Results A total of 15 case-controll study were included,including 1 983 ［mainly AECOPD (including pulmonary function grades Ⅰ, Ⅱ, Ⅲ,Ⅳ), and a few of them are stable phase of COPD when entering the group or entering stable stage after treatment］
patients and 782 healthy people.The Meta-analysis showed that:(1) The sUA of AECOPD group was significantly higher than that of healthy control group (SMD=2.05,95%CI:1.55-2.55,P<0.01).(2)sUA of patients with AECOPD before treatment was significantly higher than that after treatment (SMD=1.03,95%CI:0.72-1.34,P<0.01).(3)There was no significant difference in sUA before and after treatment in patients with AECOPD (MD=-11.23,95%CI:-53.63-31.17,P>0.05).(4)The sUA of patients with improved AECOPD after treatment was significantly lower than that before treatment (SMD=1.30,95%CI:0.79-1.80,P<0.01).(5)sUA in AECOPD group was significantly higher than that in COPD stable period group (SMD=2.54,95%CI:0.46-4.62,P<0.05).(6)sUA of COPD patients in stable stage was significantly higher than that of healthy control group (SMD=0.82,95%CI:0.39-1.25,P<0.01).(7)From the stable COPD patients with grade Ⅰ to the grade Ⅳ the level of sUA increased gradually (P<0.01).
Conclusion With the exacerbation of COPD patients,especially in the acute exacerbation stage,the level of sUA gradually increased,which can be used as an important indicator to judge the severity of COPD patients,the urgency of the disease and evaluate the treatment effect.
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