Meta⁃analysis of the level of circulating endothelial progenitor cells in patients with stable chronic obstructive pulmonary disease
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摘要:
目的：采用Meta分析综合评价慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）稳定期患者循环内皮祖细胞（circulating endothelial progenitor cells，cEPCs）水平的变化规律。方法：利用计算机检索Pubmed、Embase、Web of science数据库，收集国内外发表的有关COPD稳定期患者cEPCs水平的文献，经质量评价后按制定标准纳入文献，应用Stata14软件进行分析。结果：共纳入12项研究，包括550例研究对象。分析结果显示，COPD稳定期患者cEPCs水平明显低于对照组，结果合并后标准化均数差（standardized mean difference，SMD）为-1.38，95% 可信区间（confidence interval，CI）为-2.01~ -0.74，Z=4.23（P < 0.001）。亚组分析提示采用流式细胞计数cEPCs，COPD稳定期患者cEPCs水平显著低于健康人水平；而采用外周EPCs集落计数法发现COPD稳定期患者cEPCs数量与健康人之间无明显统计学差异。以敏感性分析、漏斗图法和剪补法分析表明结果稳定、可信。结论：COPD稳定期患者cEPCs水平较正常人显著降低，可能会减弱COPD内皮修复功能，特别是在采用流式细胞计数cEPCs时。
Abstract:
Objective：To analyze the level of circulating endothelial progenitor cells（cEPCs）in patients with stable chronic obstructive pulmonary disease（COPD）. Methods：Major online database including Pubmed，Embase，Web of science were searched to find published case-control studies on the association between cEPCs and patients with stable COPD. The results were analyzed using Stata14 software. Results：A total of 12 studies containing 550 subjects were enrolled. Meta analysis showed that the level of cEPCs was significantly declined in patients with stable COPD（standardized mean difference（SMD）= -1.38，95% confidence interval（CI）（-2.01，-0.74），Z=4.23（P < 0.001）. Subgroup analysis indicated that using flow cytometry the level of cEPCs was remarkable decresed in patients with stable COPD than normal controls；however，there is no statistic significance in the level of cEPCs between patients with stable COPD and controls by counting EPCs colony forming units. By sensitivity analysis，funnel plot，and “trim and fill”，it showed that the results were robust. Conclusion：The level of cEPCs is low in patients with stable COPD compared with healthy controls，especially by the method of flow cytometry，which may lead to the deficient capacity of endothelial repairing.
