Li Yanqing, Wang Peihong, Li Lei, Wang Fei, Liu Yuxiu
Department of Pharmacy Intravenous Admixture Services, Affiliated Hospital of Weifang Medical University, Weifang.
Department of Interventional Oncology, Weifang Tumor Hospital, Weifang.
Ther Clin Risk Manag. 2018 Jan 23;14:157-165. doi: 10.2147/TCRM.S157085. eCollection 2018.
Polymyositis and dermatomyositis (PM/DM) have been implicated in the development of venous thromboembolism (VTE). Previous studies investigating the association between PM/DM and VTE risk had yielded inconsistent findings. The aim of this study was to precisely estimate this association by meta-analysis of all available publications.
Two investigators independently performed a comprehensive literature search in databases of PubMed, Embase, and the Cochrane Library for eligible studies. The strength for the association was weighed by pooled odds ratios (ORs) with 95% confidence intervals (95% CIs). Stratified analysis and sensitivity analysis were performed for further analysis.
Six studies including 9,045 patients with PM/DM were analyzed. The pooled OR suggested that inflammatory myositis was associated with increased risk of VTE (OR =4.31, 95% CI: 2.55-7.29, <0.001). Besides, significantly elevated risk of VTE was related with PM and DM, respectively (for PM: OR =6.87, 95% CI: 4.12-11.46, <0.001; for DM: OR =11.59, 95% CI: 6.54-20.55, <0.001). In addition, inflammatory myositis could increase the risk of DVT (OR =4.85, 95% CI: 1.38-17.12, <0.05) and PE (OR =4.74, 95% CI: 2.18-10.30, <0.05). Sensitivity analysis did not materially alter the pooled results.
Our study shows strong evidence that patients with inflammatory myositis have an increased risk of VTE.
多发性肌炎和皮肌炎(PM/DM)与静脉血栓栓塞症(VTE)的发生有关。以往研究PM/DM与VTE风险之间关联的结果并不一致。本研究旨在通过对所有可得出版物进行荟萃分析来精确评估这种关联。
两名研究者独立在PubMed、Embase和Cochrane图书馆数据库中进行全面文献检索,以查找符合条件的研究。关联强度通过合并比值比(OR)及95%置信区间(95%CI)来衡量。进行分层分析和敏感性分析以作进一步分析。
对6项研究(共9045例PM/DM患者)进行了分析。合并OR表明,炎性肌炎与VTE风险增加相关(OR = 4.31,95%CI:2.55 - 7.29,<0.001)。此外,VTE风险显著升高分别与PM和DM相关(对于PM:OR = 6.87,95%CI:4.12 - 11.46,<0.001;对于DM:OR = 11.59,95%CI:6.54 - 20.55,<0.001)。此外,炎性肌炎可增加深静脉血栓形成(DVT)风险(OR = 4.85,95%CI:1.38 - 17.12,<0.05)和肺栓塞(PE)风险(OR = 4.74,95%CI:2.18 - 10.30,<0.05)。敏感性分析未实质性改变合并结果。
我们的研究有力证明炎性肌炎患者发生VTE的风险增加。