摘要
目的分析血液炎症标志物水平与儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)的关系,为儿童ADHD的早期干预及预防提供依据。方法检索截至2022年5月20日发表在PubMed、Embase、Web of Science、the Cochrane Library、中国知网(CNKI)、万方数据知识服务平台、维普中文期刊服务平台、中国生物医学文献数据库的相关文献,由2名研究者独立进行文献筛选、资料提取和质量评价。RevMan 5.3和Stata 16.0软件用于Meta分析和发表偏倚检验。结果最终纳入15篇文献,总样本量为2199例。Meta分析结果显示,ADHD组血清白细胞介素-6(interleukin-6,IL-6)水平显著高于健康对照组(SMD=0.98,95%CI:0.10~1.86,P=0.03);亚组分析发现,非洲国家ADHD组血清IL-6水平高于健康对照组(P<0.001),病例组和健康对照组总样本量为60例、100~120例的研究,其ADHD组血清IL-6水平高于健康对照组(P<0.001)。ADHD组血清IL-1β水平与健康对照组比较,差异无统计学意义(SMD=0.70,95%CI:-0.46~1.86,P=0.24)。ADHD组血清TNF-α水平与健康对照组比较,差异无统计学意义(SMD=-0.26,95%CI:-1.29~0.77,P=0.62)。ADHD组血液中性粒细胞计数与淋巴细胞计数比值(neutrophil-to-lymphocyte ratio,NLR)显著高于健康对照组,差异有统计学意义(SMD=0.63,95%CI:0.25~1.01,P=0.001),亚组分析发现,ADHD组样本量<100例的研究其ADHD组NLR高于健康对照组,差异有统计学意义(SMD=0.71,95%CI:0.47~0.96,P<0.001)。结论ADHD患儿血清IL-6水平、NLR比健康儿童高,提示血液炎症标志物可能在ADHD的发病机制中发挥关键作用,抗炎措施可能对ADHD的防治有积极意义。
Objective To analyze the relationship between the level of blood inflammatory markers and attention deficit hyperactivity disorder(ADHD)in children,and to provide evidence for early intervention and prevention of ADHD.Methods Relevant literatures published in PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang Data Knowledge Service Platform,VIP Chinese Journal Service Platform,and China Biomedical Literature Database were retrieved as of May 20,2022.Two investigators independently screened the literature and extracted information,and carried out quality evaluation.RevMan 5.3 and Stata 16.0software were used for Meta-analysis and publication bias testing.Results A total of 15 literatures were included,with a total sample size of 2199 cases.Meta-analysis results showed that:the serum interleukin-6(IL-6)level in ADHD group was significantly higher than that in healthy control group(SMD=0.98,95%CI:0.10-1.86,P=0.03);subgroup analysis found that the serum IL-6 level in the ADHD group in African countries was higher than that in the healthy control group(P<0.001);for studies with a total sample size of 60 cases,100-120 cases in the case and control groups,the serum IL-6 level in the ADHD group was higher than that in the healthy control group(P<0.001).There was no significant difference in serum IL-1βlevel between ADHD group and healthy control group(SMD=0.70,95%CI:-0.46-1.86,P=0.24).There was no significant difference in serum TNF-αlevel between ADHD group and healthy control group(SMD=-0.26,95%CI:-1.29-0.77,P=0.62).The blood neutrophil-to-lymphocyte ratio(NLR)of ADHD group was significantly higher than that of healthy control group(SMD=0.63,95%CI:0.25-1.01,P=0.001),subgroup analysis found that the NLR value of ADHD group was higher than that of healthy control group in studies with a sample size of less than 100 cases(SMD=0.71,95%CI:0.47-0.96,P<0.001).Conclusion Serum IL-6 levels and NLR values were higher in children with ADHD than in healthy children,suggesting that blood inflammatory markers may play a ke
作者
李雪军
王淑敏
张奕星
姜之炎
肖臻
LI Xuejun;WANG Shumin;ZHANG Yixing(Department of Pediatrics,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《医学研究杂志》
2023年第11期74-83,共10页
Journal of Medical Research
基金
上海市进一步加快中医药传承创新发展三年行动计划(2021年-2023年)项目[ZY(2021-2023)-0206-01]
上海市“十三五”临床重点专科项目(shslczdzk04102)
上海中医药大学附属龙华医院科技创新项目(KY22059)。
关键词
注意缺陷多动障碍
血液炎症标志物
META分析
儿童
Attention deficit hyperactivity disorder
Blood inflammatory markers
Meta-analysis
Children
