中国儿童精神发育迟滞致病生物因素的Meta分析  

Meta-analysis on major risk biological factors of mental retardation in China

作　　者：李静[1] 陈继顺[1] 强旭 费可可 陈梦婷[1] 张科进[1] 高晓彩[1] 李军林[1] LI Jing CHEN Jishun QIANG Xu FEI Keke CHEN Mengting ZHANG Kejin GAO Xiaocai LI Junlin(Institute of Population and Health, Northwest University, Xi＇an 710069, China)

机构地区：[1]西北大学人口与健康研究所,陕西西安710069

出　　处：《西北大学学报（自然科学版）》2016年第5期711-715,共5页Journal of Northwest University（Natural Science Edition）

基　　金：教育部人文社会科学研究基金资助项目(13YJCZH081);NSFC基地建设能力提高基金资助项目(J1210063);国家自然科学基金资助项目(31371327);陕西省教育厅自然科学基金资助项目(ZS11005和11JS094)

摘　　要：评价近20多年来(1992—2016)中国儿童精神发育迟滞(Mental retardation,MR)发病状况与病因,为MR预防和干预提供基础资料。以精神发育迟滞或智力低下为关键词,以风险因素和病例-对照为联合关键词,检索中国期刊全文数据库、维普数据库和万方数据库有关MR的研究论文。对筛选的文献,采用Revman软件(version 5.0)合并分析筛选出的数据。共纳入相关文献486篇,按照标准筛选出15篇文献,涉及MR儿童7329例,正常对照7511例。数据分析结果表明,在发病风险因素中,新生儿体重低下、MR家族史和早产具有异质性,而产时窒息和父母近亲结婚具有较高的一致性。Meta分析显示MR各因素合并比值依次为:MR家族史(9.90)、产时窒息(7.73)、父母近亲结婚(6.36)、难产(5.60)、早产(4.36)和出生时低体重(3.08)。近20多年来,中国儿童MR发生影响因素中,家族性遗传仍然是高风险因素,提示积极开展遗传咨询和指导有助于降低MR的发生;其次,产时因素是另一大类风险因素,提高医务人员素质,增强育龄夫妇保健意识,加强围产期孕妇的监护,将会有效降低后天因素导致MR的发生。In order to provide basic data and evidence supporting potent prevention and interference of mental retardation （MR） occurrence, an integration evaluation was carried out based upon relative reports about mor-bidity and causes of MR published in Chinese from 1992 to 2016. The key words including risk factors, casecontrol, mental retardation or intellectual disability were selected for searching in the databases of China Na-tional Knowledge Infrastructure （ CNKI）, VIP and Wanfang. The selected data were conflated and analyzed by using Revman software （Version 5.0）. The potential publication bias was analyzed with Egger＇s test. In total,486 articles were screened out, and among those 15 closely-related publications were selected. Totally 7329 cases of MR and 7511 controls were included. Meta analysis was carried out. The results demonstrated that underweight of newborns, family history of MR and premature birth are heterogeneous factors, while both intrapartum asphyxia and inbreeding are consistency ones. the highest pool odds ratio （OR） value was that of family history （9.90）, followed by intrapartum asphyxia （7.73）, inbreeding parents （6. 36 ）, difficult labor （5.60）, premature birth （4.36）, and underweight of newborns （3.08）. Among the risk factors, the family history of MR is still the dominant reason. Continuing implementing genetic consultation and guidance support would be helpful in reducing the risk of MR. In addition, the intrapartum factor should be also paid attention. All efforts, including improving professional characteristic of medical personnel, enhancing individual health consciousness of married couples, and strengthening the monitoring on perinatal pregnant women, should be made to reduce the MR occurrence. The measures proposed are meaningful in preventing MR occurrence and improving the quality of general population in China.

关 键 词：精神发育迟滞 影响因素 病例-对照研究 META分析 

分 类 号：R174[医药卫生—妇幼卫生保健]