心脏/肺移植人群痛风患病率的荟萃分析与系统评价
Meta-analysis and systematic review of gout prevalence in the heart/lung transplantation population.
作者信息
Chui Benedict, Day Richard, Umashankar Eshwar, Abdel Shaheed Christina, Keogh Anne, Girgis Laila, Penglase Ross
机构信息
Faculty of Medicine and Health, St Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia.
Department of Clinical Pharmacology, St Vincent's Hospital, Sydney, NSW, Australia.
出版信息
Front Transplant. 2024 May 20;3:1356058. doi: 10.3389/frtra.2024.1356058. eCollection 2024.
INTRODUCTION
Gout may complicate solid organ transplantation with potentially serious consequences. An accurate prevalence of gout in this population is unknown.
OBJECTIVES
This study aimed to estimate the prevalence of gout in the heart and/or lung transplantation population through a systematic review and meta-analysis.
METHODS
MEDLINE, Embase, PsycINFO, CENTRAL and Cochrane Library (inception to February 2022) were searched for studies that reported the prevalence and/or incidence of gout in heart and/or lung transplant recipients. Two authors extracted outcomes data. Data were pooled using a random effects model. Overall quality of evidence was assessed using GRADE. Primary outcomes were the prevalence of pre- or post-transplant gout expressed as a prevalence rate (95% CI). Secondary outcomes included risk factors for gout, adverse events, and therapeutic complications of gout treatment.
RESULTS
Ten studies were included. Gout prevalence (PR) was 8% pre-transplant (PR = 0.08; 95% CI: 0.05-0.12; 4 studies = 651) and 6% post-transplant (PR = 0.06; 95% CI: 0.06-0.06; 10 studies = 45,298). Post-transplant gout prevalence in heart transplant recipients was almost three times higher than lung transplant recipients (PR = 0.16; 95% CI: 0.13-0.20 vs. PR = 0.06; 95% CI: 0.05-0.06 respectively). Patients with a pre-transplant history of gout had a higher risk of developing post-transplant gout than patients without (RR = 3.61; 95% CI: 2.19-5.95). Factors associated with gout and outcomes for heart and/or lung transplant recipients with gout were comprehensively reviewed from the included studies.
CONCLUSION
Gout is highly prevalent in heart and/or lung transplant patients. Pre-transplant gout is predictive of developing symptomatic post-transplant gout. This has significant implications for management of heart/lung transplant patients.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/, PROSPERO (CRD42020190632).
引言
痛风可能使实体器官移植复杂化，带来潜在的严重后果。该人群中痛风的确切患病率尚不清楚。
目的
本研究旨在通过系统评价和荟萃分析估计心脏和/或肺移植人群中痛风的患病率。
方法
检索MEDLINE、Embase、PsycINFO、CENTRAL和Cochrane图书馆（建库至2022年2月），查找报告心脏和/或肺移植受者痛风患病率和/或发病率的研究。两名作者提取结局数据。采用随机效应模型合并数据。使用GRADE评估证据的总体质量。主要结局是以患病率（95%CI）表示的移植前或移植后痛风患病率。次要结局包括痛风的危险因素、不良事件以及痛风治疗的治疗并发症。
结果
纳入10项研究。移植前痛风患病率（PR）为8%（PR = 0.08；95%CI：0.05 - 0.12；4项研究，n = 651），移植后为6%（PR = 0.06；95%CI：0.06 - 0.06；10项研究，n = 45,298）。心脏移植受者移植后痛风患病率几乎是肺移植受者的三倍（PR分别为0.16；95%CI：0.13 - 0.20和PR = 0.06；95%CI：0.05 - 0.06）。有移植前痛风病史的患者发生移植后痛风的风险高于无此病史的患者（RR = 3.61；95%CI：2.19 - 5.95）。从纳入的研究中全面回顾了与痛风相关的因素以及心脏和/或肺移植痛风受者的结局。
结论
痛风在心脏和/或肺移植患者中高度流行。移植前痛风可预测移植后出现症状性痛风。这对心脏/肺移植患者的管理具有重要意义。
系统评价注册
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