广西医学

目的系统评价中国儿童Toll样受体（TLRs）基因多态性与肠道病毒71型（EV71）感染手足口病易感性和严重程度的相关性。方法计算机检索PubMed、The Cochrane Library、Embase、Web of Science、中国知网、中国生物医学文献服务系统数据库、万方数据知识服务平台数据库和中文期刊服务平台数据库，收集自建库至2025年8月的中国儿童TLRs基因多态性与EV71感染手足口病的病例对照研究，提取相关数据并进行文献质量评价后，采用RevMan 5.4软件和Stata 15.1软件进行Meta分析。结果共纳入TLR3基因多态性文献5篇，TLR7基因多态性文献5篇。Meta分析结果显示，TLR3 rs3775290和TLR7 rs179019位点的各个基因型均与EV71手足口病易感性无明显相关性（P>0.05），TLR7 rs3853839位点C等位基因、GC基因型女性患儿为EV71感染手足口病的危险因素（P<0.05）。TLR3 rs3775291、TLR3 rs5743303、TLR7 rs179009和TLR7 rs179019位点的各个基因型均与EV17感染手足口病的疾病严重程度无相关性（P>0.05）。TLR3 rs3775290位点的T等位基因会增加EV17感染手足口病重症化风险。TLR7 rs179016女性患儿的GC型相较于GG型重症化风险增加，而GG型对比GC+CC型为重症的保护因素（P<0.05）。TLR7 rs3853839男性患儿C等位基因是EV17感染手足口病重症的危险因素（P<0.05）。结论 TLR7 rs3853839位点C/G等位基因可能与EV71 感染手足口病易感性相关，TLR3 rs3775290位点T/C等位基因、女童TLR7 rs179016位点C/G等位基因、男童TLR7 rs3853839位点C/G等位基因可能与EV71感染手足口病疾病严重程度相关，而其他基因位点尚需更多证据说明其相关性。

Objective To systematically evaluate the correlation between Toll⁃like receptors (TLRs) gene polymorphisms and susceptibility and severity of enterovirus 71 (EV71)⁃infected hand⁃foot⁃mouth disease (HFMD) in Chinese children. Methods Databases including PubMed, The Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, China Biomedical Literature Service System Database, WanFang Data Knowledge Service Platform, and VIP were searched via computer to collect case⁃control studies on TLRs gene polymorphisms and EV71⁃infected HFMD in Chinese children from database inception to August 2025. After extracting relevant data and assessing literature quality, Meta⁃analysis was performed using RevMan 5.4 and Stata 15.1 software. Results A total of 5 studies on TLR3 gene polymorphisms and 5 studies on TLR7 gene polymorphisms were included. Meta⁃analysis results revealed that various genotypes at TLR3 rs3775290 and TLR7 rs179019 loci were not significantly correlated with susceptibility to EV71⁃infected HFMD (P>0.05). For TLR7 rs3853839 locus, C allele and GC genotype in female children were risk factors for EV71⁃infected HFMD (P<0.05). Various genotypes at TLR3 rs3775291, TLR3 rs5743303, TLR7 rs179009, and TLR7 rs179019 loci were not correlated with disease severity of EV71⁃infected HFMD (P>0.05). T allele of TLR3 rs3775290 locus would increase risk of severe disease of EV17⁃infected HFMD. For TLR7 rs179016 locus, female children with GC genotype had an increased risk of severe disease compared to those with GG genotype, while GG genotype was a protective factor against severe disease compared to GC+CC genotype (P<0.05). For TLR7 rs3853839 locus, C allele in male children was a risk factor for severe EV71⁃infected HFMD (P<0.05). Conclusion C/G alleles at TLR7 rs3853839 locus may be correlated with susceptibility of EV17⁃infected HFMD, T/C alleles of TLR3 rs3775290 locus, female children with C/G alleles at TLR7 rs1790196 locus, male children with C/G alleles at TLR7 rs3853839 locus may be correlated with severity of EV17⁃infected HFMD, whereas more evidence is needed to clarify the correlations of other gene loci.