首页|43例中国儿童Ⅰ型唾液酸沉积症眼部与神经系统表现相关性的meta分析

43例中国儿童Ⅰ型唾液酸沉积症眼部与神经系统表现相关性的meta分析

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目的 探讨中国儿童Ⅰ型唾液酸沉积症(SD)眼底"樱桃红斑"(CS)与神经系统表现的相关性。方法 循证医学研究。以"中国"、"唾液酸沉积症"、"Sialidosis"、"Sialidoses"、"China"为中英文检索词,在中国知网、万方科技期刊全文数据库、美国国立医学图书馆医学数据库PubMed进行检索。病例均来自中国且符合Ⅰ型SD诊断标准。根据眼底检查有(+)无(-)CS表现,将患儿分为CS+组、CS-组。采用RevMan 5。3软件对眼底CS发生与神经系统表现的相关性进行统计学分析。结果 根据检索策略初步检索出68篇文献,最终纳入17篇文献进行分析;对其中同时纳入CS+、CS-患儿的5篇文献进行meta分析。共纳入SD患儿43例。其中,男性28例,女性15例;发病年龄中位数12岁。视力下降、眼底CS分别为37(90。2%,37/41;无记录2例)、24(55。8%,24/43)例;肌阵挛、共济失调、癫痫分别为42(97。7%,42/43)、39(95。1%,39/41;无记录2例)、32(91。4%,32/35;无记录8例)例。42例为NEU1基因突变所致,1例无记录。CS+组、CS-组癫痫发作分别为20(100。0%,20/20)、12(80。0%,12/15)例,CS+组癫痫发生率较CS-组明显增高。Meta分析结果显示,CS+组、CS-组患儿肌阵挛或共济失调[相对危险度(RR)=1。13,95%可信区间(CI)0。79~1。63,P=0。49]、癫痫(RR=1。13,95%CI0。84~2。06,P=0。24)发生率比较,差异均无统计学意义。结论 中国人群儿童Ⅰ型SD眼底CS发生率为55。8%;其与神经系统表现无相关性,但伴CS者癫痫发生率明显高于不伴CS者。
Meta-analysis of the correlation between ocular and neurological manifestations in 43 Chinese children with sialidosis type Ⅰ
Objective To investigate the correlation between macular cherry red spot(CS)and severity of neurological manifestations in Chinese children with sialidosis(SD)type Ⅰ.Methods A evidence-based medical study."China","Sialidosis"and"Sialidoses"were used as Chinese and English search terms.The literature was searched in CNKI,Wanfang and PubMed.The cases were all from China and matched the diagnostic criteria.According to the presence or absence of CS in the fundus,the SD children were divided into a group with CS(+)and a group without CS(-),and the correlation between the occurrence of ocular CS and neurological manifestations was compared with meta-analysis by RevMan 5.3 software.Results Sixty-eight studies were initially retrieved according to the search strategy,and 17 studies were finally included,and 5 studies with CS+and CS-were meta-analyzed.Among the 43 patients,28 were male and 15 were female,with a median age of 12 years.Visual impairment was observed in 37 cases(90.2%,37/41,2 cases not recorded),and CS was present in 24 cases(55.8%,24/43).The most common neurological manifestation was myoclonus(97.7%,42/43),followed by cerebellar ataxia(95.1%,39/41,2 cases not recorded)and seizures(91.4%,32/35,8 cases not recorded).Pathogenic NEU1 gene mutations were detected in 42 cases and one case was undocumented.The incidence of seizure in group CS+(100%,20/20)was higher than that in group CS-(80%,12/15).Meta-analysis showed that there was no statistically significant difference between the incidence of myoclonus or ataxia[relative risk(RR)=1.13,95%confidence interval(CI)0.79-1.63,P=0.49]and seizure(RR=1.13,95%CI 0.84-2.06,P=0.24)among the children in the CS+and CS-groups.Conclusions The incidence of ocular CS in Chinese children with type Ⅰ SD was 55.8%.There was no correlation with neurological manifestations,however the incidence of seizure was significantly higher in patients with CS than in others without CS.

SialidosisCherry red-spotChinese childrenAtaxiaDiagnostic valueMeta-analysis

左华欣、周晓芳、任晓暾、施维、李莉、余继锋、彭春霞

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首都医科大学附属北京儿童医院眼科国家儿童医学中心,北京 100045

首都医科大学附属北京儿童医院神经内科国家儿童医学中心,北京 100045

唾液酸沉积症 樱桃红斑 中国儿童 共济失调 诊断价值 Meta分析

北京市属医院科研培育计划项目

PX2023046

2024

中华眼底病杂志
中华医学会

中华眼底病杂志

CSTPCD北大核心
影响因子:0.928
ISSN:1005-1015
年,卷(期):2024.40(1)
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