吸烟与子宫内膜异位症发病风险的Meta分析  

Smoking and Risk of Endometriosis: A Meta-Analysis of Case Control Studies

作　　者：杨润峰[1] 马衣努尔.买提托合提 吴章颖[1] 王恬[1] 汪雯雯[1] 栗妍[1] 王世宣[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院妇产科,武汉430030

出　　处：《中国循证医学杂志》2012年第1期68-73,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价吸烟与子宫内膜异位症发病的相关性,为进行人群健康教育和预防决策提供依据。方法计算机检索Cochrane图书馆、PubMed、EMbase、CBM、CNKI和WanFang Data等数据库,查找吸烟与子宫内膜异位症发病风险的临床研究,由两名评价员独立按照纳入与排除标准选择文献、提取资料和评价质量后,对符合纳入标准的13个病例对照研究,采用RevMan 5.0软件进行Meta分析,计算其合并OR值和95%CI并对发表偏倚进行漏斗图分析。结果共纳入13个病例对照研究,共14 260例,其中子宫内膜症患者1 900例。方法学质量评价结果显示,2个研究为A级,4个为B级,剩余7个均为C级,总体研究质量不高。Meta分析结果显示,不吸烟人群与吸烟人群比较,其罹患子宫内膜异位症的几率未见增加[OR=0.91,95%CI(0.82,1.02)]。按地域进行亚组分析,结果显示北美洲人群的OR合并为0.96[95%CI(0.84,1.08)],吸烟组和非吸烟组子宫内膜异位症发病率差异无统计学意义,但欧洲人群的OR合并为0.72[95%CI(0.54,0.97)],吸烟组和非吸烟组子宫内膜异位症发病率差异有统计学意义。结论目前研究尚未见吸烟与否对子宫内膜异位症发病率有影响。由于各研究间存在异质性,且方法学质量较差,上述结论尚需开展更大样本量的前瞻性研究进一步证实。Objective To systematically assess the correlation between smoking and the risk of endometriosis, so as to offer scientific basis to health education and preventing decision. Methods A literature search was performed in The Cochrane Library, Pubmed, Embase, CBM, CNKI and Wanfang database to collect the case control studies on the correlation between smoking and endometriosis. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria, extracted the data, assessed the quality, and then conducted Meta-analyses on the 13 included RCTs by using RevMan 5.0 software, with calculation of the OR value and 95%CI. Results A total of 13 case control studies involving 14260 cases were included, of which 1900 ones were endometriosis. The quality assessment indicated that 2 studies were in quality of Level A, 4 were Level B, 7 were Level C, totally meant low quality. Meta-analyses showed that compared with non-smokers, there was no increasing possibility of endometriosis in smokers （OR= 0.91, 95%CI 0.82 to 1.02）. The geographical subgroup analyses showed there was no significant difference in the incidence of endometriosis between the non-smokers and smokers in North America （OR=0.96, 95%CI 0.84 to 1.08）, but a significant difference was found between non-smokers and smokers in Europe （OR=0.72, 95%CI 0.54 to 0.97）. Conclusion There is no causative relationship between smoking and incidence of endometriosis. However, more high-quality trials are expected for further study because of the heterogeneity and poor quality of the current included studies.

关 键 词：子宫内膜异位症 吸烟 发病率 病例对照研究 META分析 

分 类 号：R711.71[医药卫生—妇产科学]