肛门生殖器距离与隐睾相关性的Meta分析  

Association of anogenital distance with pediatric cryptorchidism： a Meta-analysis

作　　者：王养才 吴盛德[1] 魏仪[1] 曹希宁[1] 刘洋[1] 沈炼桔[1] 龙春兰[1] 林涛[1] 何大维[1] 魏光辉[1] 

机构地区：[1]重庆医科大学附属儿童医院泌尿外科、儿童发育疾病研究教育部重点实验室、重庆医科大学附属儿童医院儿科研究所、重庆市儿童发育重大疾病国家国际科技合作基地、儿科学重庆市重点实验室,400014

出　　处：《中华小儿外科杂志》2017年第11期849-853,共5页Chinese Journal of Pediatric Surgery

基　　金：国家自然科学基金（81370701,81571425）;国家临床重点专科建设项目资助（国卫办医函[2013]544号）

摘　　要：目的探讨肛门外生殖器距离（anogenital distance，AGD）与隐睾的相关性。方法检索国外数据库Pubmed、Embase、Medline以及国内数据库CNKI、VIP、万方（检索时限从1990年1月至2016年1月）。查找关于外生殖器距离与隐睾相关性的病例对照研究，文献初步检索出80篇，其中Pubmed，Embase共有79篇，中文数据库检索出1篇。由两人单独筛选并且评价文献。最终纳入5篇文献。应用Stata12.0软件进行Meta分析，计算合并统计量（weighted mean difference，WMD）以及95%的可信区间（confidence intervals，CI）。对纳入研究进行异质性评价后，依据患儿年龄，进行亚组分析，对纳入文献进行敏感性分析以及发表偏移的评估。结果共有5篇符合纳入标准的临床研究。依据年龄分为两个亚组，Meta分析结果显示：在新生儿组，隐睾患儿的肛门外生殖器距离（AGD）小于健康对照组[WMD＝－0.34，95%CI（－0.40，－0.29），P〈0.05]，差异具有统计学意义。在非新生儿组，隐睾患儿的肛门外生殖器距离（AGD）与对照组差异无统计学意义[WMD＝－0.07，95%CI（－0.23，0.10），P＝0.429]。敏感性分析以及发表偏倚的分析提示：所纳入的研究不存在导致合并效应量结果较大差异的研究，各项研究之间不存在发表偏倚。结论新生儿隐睾患儿的肛门外生殖器距离（AGD）较健康男婴短，平均差值约0.34 cm；新生儿AGD可能一定程度上反映体内激素水平的变化以及雄性化的水平。但在非新生儿中，因多种混杂因素的影响，其AGD的长短与隐睾的相关性，尚需更多的临床研究来证实。ObjectiveTo explore the association of anogenital distance （AGD） with pediatric cryptorchidism.MethodsThe case-control studies involving association of AGD with susceptibility to cryptorchidism were retrieved through computer-based searches in PubMed, Embase, Medline, CNKI, VIP and WanFang Data （January 1990 to January 2016）. A total of 80 studies were identified from literature searches in PubMed, Embase, CNKI, VIP and Wangfang Data. Five studies were independently evaluated by two reviewers. Statistical analysis was performed by STATA 12.0 software. Pooled weighted mean difference （WMD） and 95% confidence interval （CI） were calculated. Evaluating the heterogeneity of five studies and subgroup analysis were based upon age. Sensitivity analysis and publication bias were carried out.ResultsA total of five eligible studies were included for meta-analysis. There was a significant association of short AGD [WMD=-0.34, 95%CI （-0.40, -0.29）, P〈0.05] with cryptorchidism in neonates. AGD between non-neonatal cryptorchidism and healthy non-neonatal had no difference [WMD=-0.07, 95%CI （-0.23, 0.10）, P=0.429]. Sensitivity analysis and publication bias showed that included studies had no publication bias.ConclusionsCryptorchidism has shorter AGD in neonates. Neonatal AGD may partly react changes in the levels of and hormones and masculine. Non-neonatal AGD have no difference in cryptorchidism and healthy controls.

关 键 词：肛门外生殖器距离 隐睾 META分析 

分 类 号：R726.9[医药卫生—儿科]