Zhang Xiao-Bin, Jiang Xing-Tang, Cai Fang-Rong, Zeng Hui-Qing, Du Yan-Ping
Department of Respiratory Medicine, Zhongshan Hospital, Xiamen University, No. 201, Hubin Nan Road, Siming District, Xiamen, 361004, Fujian Province, China.
Teaching Hospital of Fujian Medical University, No. 201, Hubin Nan Road, Siming District, Xiamen, 361004, Fujian Province, China.
Eur Arch Otorhinolaryngol. 2017 Feb;274(2):661-670. doi: 10.1007/s00405-016-4102-6. Epub 2016 May 28.
Published articles regarding the blood levels of vascular endothelial growth factor (VEGF) in obstructive sleep apnea (OSA) patients are contradictory. The objective of this study was to explore whether VEGF levels is high or not in OSA subjects via quantitatively statistical analysis. The electronic databases of Pubmed, Web of Science, EMBASE were systematic searched. The VEGF levels and clinical characteristics of participants between OSA group and control group were extracted for analysis. Weighted mean difference (WMD) or standard mean difference (SMD) with 95 % confidence interval (CI) was calculated by fixed effects or random effects model. Appropriate statistical software was employed for data synthesis. Totaling 15 articles with 697 participants were included in this study. Pooled meta-analysis showed that blood VEGF concentrations were significantly higher in OSA patients than in control subjects (SMD 1.89, 95 % CI 0.92-2.87, p = 0.000). Subgroup analysis demonstrated that when compared with control group, OSA patients with age ≥50 years (SMD 2.54, 95 % CI 1.28-3.80, p = 0.000), apnea hypopnea index ≥30 events/h (SMD 2.47, 95 % CI 1.20-3.73, p = 0.000) had higher VEGF levels. Compared with control subjects, OSA patients had an elevated VEGF in serum (SMD 3.55, 95 % CI 1.82-5.28, p = 0.000) rather than in plasma. High blood VEGF concentrations were observed in OSA patients, particularly in the older and more serious patients.
关于阻塞性睡眠呼吸暂停(OSA)患者血管内皮生长因子(VEGF)血液水平的已发表文章相互矛盾。本研究的目的是通过定量统计分析探讨OSA患者的VEGF水平是否升高。对Pubmed、科学网、EMBASE等电子数据库进行了系统检索。提取OSA组和对照组参与者的VEGF水平及临床特征进行分析。采用固定效应或随机效应模型计算加权平均差(WMD)或标准化平均差(SMD)及95%置信区间(CI)。使用适当的统计软件进行数据合成。本研究共纳入15篇文章,697名参与者。汇总的荟萃分析表明,OSA患者的血液VEGF浓度显著高于对照组(SMD 1.89,95%CI 0.92 - 2.87,p = 0.000)。亚组分析表明,与对照组相比,年龄≥50岁的OSA患者(SMD 2.54,95%CI 1.28 - 3.80,p = 0.000)、呼吸暂停低通气指数≥30次/小时的OSA患者(SMD 2.47,95%CI 1.20 - 3.73,p = 0.000)的VEGF水平更高。与对照组相比,OSA患者血清中的VEGF升高(SMD 3.55,95%CI 1.82 - 5.28,p = 0.000),而非血浆中的VEGF升高。在OSA患者中观察到高血液VEGF浓度,尤其是在年龄较大和病情较严重的患者中。