目的 探究抽动障碍儿童血清微量元素含量与正常健康儿童的差异,为抽动障碍的防治提供参考。方法 检索中国知网数据库(CNKI)、重庆维普中文科技期刊数据库(VIP)、万方数据库(Wanfang Data)、临床试验注册中心、Pubmed、Embase、Cochrane Library及Web of Science等数据库,检索词包括抽动障碍、微量元素、血铅、血锌、血铁等,收集检测抽动障碍患儿血清锌、铁、铅、铜、镁、钙等元素数值的病例-对照研究,运用RevMan 5.3及Stata15进行Meta分析。结果 最终纳入中英文文献共19篇,时间跨度为15年,纳入抽动障碍患儿共3 762例,对照组健康儿童共4 800例。Meta分析结果显示:相比于正常健康儿童,抽动障碍患儿的血铅水平更高(MD=23.75,95%CI:13.57~33.92, P＜0.001),血铁(MD=-62.64,95%CI:-84.35~-40.93, P＜0.001)、锌(MD=-0.87, 95%CI:-1.19~-0.55, P＜0.001)水平偏低,而血镁、血钙与血铜水平差异无统计学意义。Logistic回归分析显示,血铅、锌、铁的异常与抽动障碍的发病相关。结论 抽动障碍患儿血清铅偏高而血清锌、铁偏低,且血清铅、锌、铁的异常可能与抽动障碍的发病相关。
Abstract
Objective To explore the difference of serum trace elements between children with tic disorder (TD) and healthy children, in order to provide reference for the prevention and treatment of TD. Methods CNKI,VIP, Wanfang, Clinical Trial Registration Center, Pubmed, Embase, Web of Science and Cochrane Library were searched to retrieve case-control studies where serum levels of zinc, iron, lead, copper, magnesium, calcium and other elements in TD children were tested.Keywords included tic disorder/TD, trace elements, blood lead, blood zinc, blood iron, etc.RevMan 5.3 and Stata 15 were used to conduct Meta-analysis. Results A total of 19 articles in Chinese and English were finally included, with a time span of 15 years.Totally 3 762 TD children and 4 800 healthy children in the control group were included.Meta-analysis results showed that compared with healthy children, TD children had higher serum level of lead (MD=23.75, 95%CI:13.57 - 33.92, P＜0.001), lower serum levels of iron (MD=-62.64, 95%CI:-84.35 - -40.93, P＜0.001) and zinc (MD=-0.87, 95%CI:-1.19 - -0.55, P＜0.001),but no significant difference was found in serum magnesium, calcium and copper(P＞0.05).Logistic regression analysis showed that the abnormality of serum lead, zinc and iron was related to tic disorder. Conclusions Children with TD have higher level of serum lead and lower level of serum zinc and iron.And the abnormality of serum lead, zinc and iron may be related to the pathogenesis of tic disorder.
关键词
抽动障碍 /
微量元素 /
血锌 /
血铁 /
血铅 /
血铜 /
血镁 /
血钙 /
Meta分析
Key words
tic disorder /
trace elements /
zinc /
iron /
lead /
copper /
magnesium /
calcium /
Meta-analysis
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