Xue Ji-Hua, Zhu Hai-Hong, Wang Jing, Chen Zhi
Ji-Hua Xue, Hai-Hong Zhu, Jing Wang, Zhi Chen, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
World J Gastroenterol. 2014 Jun 21;20(23):7505-13. doi: 10.3748/wjg.v20.i23.7505.
To investigate the association of hypertension and diabetes mellitus (DM) with interferon-associated retinopathy (IAR) risk in chronic hepatitis C (CHC).
Two investigators independently searched PubMed and Embase for eligible articles published prior to December 2013; additional studies were identified by reviewing the bibliographies. Only case-control or cohort studies that evaluated the association between hypertension and/or DM and IAR incidence in CHC patients were included. IAR was characterized by the presence of cotton-wool spots and/or retinal hemorrhage, and was defined as the primary efficacy measure. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were estimated using data extracted from papers based on random-effects models.
Eight eligible studies were included in the present meta-analysis. The outcomes showed that patients with CHC and hypertension were at higher risk of IAR (48/189 vs 96/455, RR = 1.90; 95%CI: 1.15-3.15, P < 0.05). Patients with DM receiving interferon (IFN)-based therapy for CHC infection may be at higher risk for IAR (18/72 vs 60/256, RR = 1.56, 95%CI: 1.11-2.20, P < 0.05); however, the outcome was not stable. There was no significant difference in IAR risk between genotype-1-infected patients and non-genotype-1-infected patients (RR = 1.09, 95%CI: 0.64-1.87, P > 0.05). Comparable incidences of IAR were also found between patients treated with pegylated interferon (PIFN) α-2a and those treated with PIFN α-2b (RR = 0.84, 95%CI: 0.56-1.24, P > 0.05) and between patients treated with IFN α and those treated with PIFN α (RR = 1.04, 95%CI: 0.72-1.50, P > 0.05).
Patients with hypertension have a higher risk of retinopathy when receiving IFN-based therapy for CHC.
探讨慢性丙型肝炎（CHC）患者中高血压和糖尿病（DM）与干扰素相关性视网膜病变（IAR）风险的关联。
两名研究者独立检索了PubMed和Embase数据库，查找2013年12月之前发表的符合条件的文章；通过查阅参考文献确定了其他研究。仅纳入评估CHC患者中高血压和/或DM与IAR发病率之间关联的病例对照研究或队列研究。IAR的特征为存在棉絮斑和/或视网膜出血，并将其定义为主要疗效指标。使用基于随机效应模型从论文中提取的数据估计合并相对风险（RRs）及95%置信区间（CIs）。
本荟萃分析纳入了8项符合条件的研究。结果显示，CHC合并高血压患者发生IAR的风险更高（48/189 vs 96/455，RR = 1.90；95%CI：1.15 - 3.15，P < 0.05）。接受基于干扰素（IFN）治疗的CHC感染合并DM患者发生IAR的风险可能更高（18/72 vs 60/256，RR = 1.56，95%CI：1.11 - 2.20, P < 0.05）；然而，结果并不稳定。基因1型感染患者与非基因1型感染患者之间IAR风险无显著差异（RR = 1.09，95%CI：0.64 - 1.87，P > 0.05）。聚乙二醇化干扰素（PIFN）α - 2a治疗患者与PIFNα - 2b治疗患者之间以及IFNα治疗患者与PIFNα治疗患者之间IAR发病率相当（RR = 0.84，95%CI：0.56 - 1.24，P > 0.05；RR = 1.04，95%CI：0.72 - 1.50，P > 0.05）。
CHC患者接受基于IFN治疗时，高血压患者发生视网膜病变的风险更高。
