作者：陈光唐，王梓力，王旭东，廖益东，徐卡娅

单位：

550004贵州省贵阳市，贵州医科大学附属医院神经外科 通信作者：徐卡娅，E-mail：xkaya@sina.com

Units：

Department of Neurosurgery, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China Corresponding author: XU Kaya, E-mail: xkaya@sina.com

关键词：

急性缺血性脑卒中; 氧化三甲胺; Meta分析;

Keywords：

Acute ischemic stroke; Trimethylamine oxide; Meta-analysis

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.086

Funds：

贵州省卫生健康委科学技术基金项目（gzwjkj2021-205）；贵州省普通高等学校青年科技人才成长项目（黔教合KY字［2021］190）；贵州医科大学2018年度学术新苗培养及创新探索专项项目（黔科合平台人才［2018］5779-44）

摘要：

目的 采用Meta分析探讨外周血氧化三甲胺(TMAO)水平与急性缺血性脑卒中(AIS)的关系,以期为明确外周血TMAO水平与AIS的关系提供循证医学证据。方法 计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据知识服务平台、维普网及中国生物医学文献数据库中有关TMAO与AIS关系的病例对照研究,检索时限从建库至2021-10-01;病例组为AIS患者,对照组为健康对照者;观察指标为外周血TMAO水平。采用Review Manager 5.3软件进行Meta分析,通过逐一剔除纳入文献进行敏感性分析,绘制倒漏斗图以直观评估纳入文献的发表偏倚。结果 最终纳入9篇文献进行Meta分析,其中英文文献7篇,中文文献2篇;中等质量文献2篇,高质量文献7篇;病例组3 469例,对照组2 453例。Meta分析结果显示,病例组患者外周血TMAO水平高于对照组〔标准化均数差(SMD)=0.88,95%置信区间(CI)(0.47,1.28),P<0.000 1〕。敏感性分析结果显示,各效应值均在总体效应值的95%CI内,表明总体结果稳定。倒漏斗图分析结果显示,各文献分布基本对称,表明发表偏倚较低。结论 现有证据表明,AIS患者外周血TMAO水平升高,而高水平TMAO可能与AIS发生有关。

Abstract：

【Abstract】　Objective To explore the relationship between peripheral blood trimethylamine oxide (TMAO) levels andacute ischemic stroke (AIS) by meta-analysis, in order to provide evidence-based medical evidence for clarifying the relationshipbetween peripheral blood TMAO levels and AIS. Methods The case-control studies on the relationship between TMAO andAIS published on Pubmed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP, and CBM database weresearched by computer. The retrieval time limit was from database set-up to October 1, 2021. The case group was AIS patients, andthe control group was healthy people. The observation index was peripheral blood TMAO level. Meta-analysis was performed byReview Manager 5.3 software, sensitivity analysis was performed by eliminating the included literature one by one, and an invertedfunnel plot was drawn to visually assess the publication bias of the included literature. Results Nine literature were finallyincluded for meta-analysis, including 7 English literature, 2 Chinese literature, 2 medium-quality literature, and 7 high-qualityliterature. There were 3 469 cases in the case group and 2 453 cases in the control group. Meta-analysis results showed that theperipheral blood TMAO level of the case group was higher than that of the control group [standardized mean difference (SMD)=0.88, 95% confidence interval (CI) (0.47, 1.28) , P < 0.000 1] . The results of sensitivity analysis showed that each effect valuewas within the 95%CI of the overall effect value, indicating that the overall result was stable. The results of the inverted funnelplot analysis showed that the distribution of each literature was basically symmetrical, indicating that the publication bias was low.Conclusion Current evidence shows that the level of TMAO in peripheral blood of patients with AIS is elevated, and high levelsof TMAO may be associated with the occurrence of AIS.

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