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目的探讨5,10-亚甲基四氢叶酸还原酶(MTHFR)基因C677T位点多态性与习惯性流产易感性关系。方法检索习惯性流产组和对照组MTHFR基因C677T位点多态性的OR值或RR值为效应指标的相关文献,符合入选标准的文献,应用RevMan 5.0软件对各研究结果进行异质性检验和效应值合并,并进行敏感性分析和偏倚评估。结果纳入MTHFR基因C677T位点多态性文献12篇,共计病例1127例,对照1119例,根据异质性检验结果,采用相应的效应模型进行合并分析。结果 MTHFR基因677位点CT、TT、CT+TT基因型的OR值为1.24(1.02～1.52)、2.20(1.31～3.68)、1.39(1.15～1.67)。各研究的敏感性分析比较稳定,漏斗图形基本对称。亚组分析结果提示亚洲地区CT、TT、TT+CT基因型的OR值分别为1.41、2.41、1.65,P=0.17、0.02、0.03。而非亚洲地区3种基因型的OR值分别为1.13、1.78、1.24,P=0.40、0.02、0.11。结论 MTHFR基因C677T位点多态性与习惯性流产的发生密切相关。尤其是MTHFR677位点TT、CT+TT基因型是亚洲人群习惯性流产的危险因素。
Objective To investigate the relationship between C677T polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) gene and susceptibility to habitual abortion. Methods The OR values or RR values of MTHFR gene C677T polymorphism in habitual abortion group and control group were used as the literature references of the selected criteria. The data of RevMan 5.0 software were used to test the heterogeneity of the results Efficacy values are combined and sensitivity analysis and bias assessment performed. Results There were 12 articles of polymorphism of C677T locus in MTHFR gene, including 1127 cases in total and 1119 cases in control group. According to the results of heterogeneity test, the corresponding effect models were used for the combined analysis. Results The OR of CT, TT and CT + TT genotypes at MTHFR gene 677 locus was 1.24 (1.02-1.52), 2.20 (1.31-3.68) and 1.39 (1.15-1.67). Sensitivity analysis of each study is relatively stable, basically symmetrical funnel graphics. The results of subgroup analysis suggested that the OR of CT, TT and TT + CT genotype in Asia were 1.41, 2.41 and 1.65 respectively, P = 0.17, 0.02 and 0.03. The OR of non-Asian genotypes were 1.13, 1.78, 1.24, P = 0.40, 0.02, 0.11, respectively. Conclusion The C677T polymorphism of MTHFR gene is closely related to the occurrence of habitual abortion. In particular, TT, CT + TT genotypes at MTHFR677 loci are risk factors for habitual abortion in Asian populations.