| 摘要 |
应用Meta分析系统评价双相障碍（bipolar disorder, BD）与C反应蛋白（C-reactive protein, CRP）水平之间的关系。方法 计算机检索MEDLINE、Cochrane Library、Web of Knowledge、中国期刊全文数据库（CNKI）、万方数据资源系统（WanFang Data）和维普中文期刊数据库（VIP），收集有关BD与CRP的横断面研究文献，检索时间截止至2018年5月。由两位研究者严格按照纳入和排除标准独立筛选文献、提取资料数据并评价纳入研究的方法学质量。运用 Stata 12.0 软件进行 Meta 分析。结果 共纳入研究文献 18 篇，包括2208例BD患者和1421例健康对照。Meta分析显示BD患者CRP浓度高于健康对照（SMD=0.52 mg/L，95% CI:0.34 ~ 0.69 mg/L，Z=5.77，P<0.001）。按照BD患者不同心境状态进行Meta分析，躁狂期、抑郁期和缓解期分别纳入9篇、6篇和8篇文献，结果显示躁狂期和抑郁期的BD患者CRP浓度均明显高于健康对照组（SMD=0.87mg/L，95% CI:0.60 ~ 1.14 mg/L，Z=6.41，P<0.001；SMD=0.95mg/L，95% CI:0.48 ~ 1.42 mg/L，Z=3.94，P<0.001），缓解期的浓度也有所升高（SMD=0.63mg/L，95% CI:0.16 ~ 1.11 mg/L，Z=2.60，P<0.01）。敏感性分析显示Meta分析结果稳定性较强。该Meta分析存在明显的发表偏倚，但其对分析结果影响较小。 结论 BD患者各个心境状态CRP浓度均较健康对照增高，证实了炎症与BD发生发展密切相关的假说，提示可以将CRP作为BD的生物标志物。
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| Abstract |
Objective To estimate the size of association between C-reactive protein and bipolar disorder using meta analysis. Methods In this meta-analysis, we searched MEDLINE, the Cochrane Library, Scopus, CNKI, WanFang Data and VIP from database inception to May, 2018, for cross-sectional studies that measured serum and plasma CRP concentrations in adult patients with bipolar disorder and healthy controls. Two authors independently selected articles according to the inclusion and exclusion criteria, extracted data and assessed the qualities of the included studies. The meta-analyses was performed by Stata 12.0 software. Results Eighteen studies comprising 2208 patients with bipolar disorder and 1421 healthy controls. The results of meta-analysis showed that CRP concentrations were significantly increased in people with BD versus controls (SMD=0.52 mg/L, 95% CI:0.34 ~ 0.69 mg/L, Z=5.77, P<0.001). CRP levels were substantially elevated in people with bipolar disorder during mania (SMD=0.87mg/L, 95% CI:0.60 ~ 1.14 mg/L, Z=6.41, P<0.001) and depression (SMD=0.95mg/L, 95% CI:0.48 ~ 1.42 mg/L, Z=3.94, P<0.001) compared to controls, and moderately higher during euthymia (SMD=0.63mg/L, Z=2.60, 95% CI:0.16 ~ 1.11 mg/L, P<0.01). Sensitivity analysis indicated that this Meta-analysis performed a good stability. This Meta-analysis had a high probability of publication bias which had a small impact on the results. Conclusion CRP levels are increased in bipolar disorder regardless of mood state, reinforce the hypothesis of an association between inflammation and BD, suggested that CRP might be a useful biomarker in BD patients.
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