Systematic Evaluation Of The Correlation Between Legg-Calve-Perthes Disease With Coagulation And Fibrinolytic System

Objective To systematically analyze the risk factors associated with coagulation and fibrinolysis in Legg-Calve-Perthes disease.Methods 1.The databases of VIP,CBM,CNKI,Wanfang,Pubmed,Cochrane,Web of Science and Embase were searched by computer and hand-picked.2.Newcastle-Ottawa scale standards were used to evaluate the quality of research,and the combination of qualitative and quantitative method to analyze the data.Results 1.A total of 20 case-control studies were included in this study.There were 1279 children with LCPD,2592 non-LCPD children and 3 types of coagulation and fibrinolysis-related factors.They belong to anticoagulant system,coagulation system and fibrinolytic system respectively.2.There were no significant difference in protein C deficiency,activated protein C resistance and antithrombin ? deficiency in the anticoagulant system(P <0.05),and no statistical significance in protein S deficiency(P> 0.05).In subgroup analysis of geography,protein C deficiency,protein S deficiency and activated protein C resistance were statistically significant in American children(P <0.05),and activated protein C resistance was statistically significant in European children(P <0.05),Protein C deficiency in Asian children was statistically significant(P <0.05).3.The results of positive anticardiolipin antibody and Factor V Leiden in the coagulation system were statistically significant(P <0.05).The results of factor ? gene G20210 A mutation and methylenetetrahydrofolate reductase gene C677 T mutation were not statistically significant(P> 0.05)).According to the geographical location of the subgroup analysis,anticardiolipin antibody positive and Factor V Leiden in the American children were statistically significant(P <0.05),but abnormalities in the coagulation system were not statistically significant in both European and Asian children(P> 0.05).4.The results of plasminogen activator inhibitor 1 gene 4G/5G polymorphism and lipoprotein(a)in fibrinolytic system had no statistically significant(P> 0.05).According to the geographic location subgroup analysis,plasminogen activator inhibitor 1 gene 4G/5G polymorphism and lipoprotein(a)were not statistically significant in the Americas,Europe and Asia(P> 0.05).Conclusion 1.Protein C deficiency,activated protein C resistance,antithrombin ? deficiency,anticardiolipin antibody positive and Factor V Leiden are risk factors for LCPD in children.2.The incidence or risk factors of LCPD are correlated with geographical location.