生殖道沙眼衣原体感染的自清除:系统性文献复习和Meta分析  

Spontaneous clearance of Chlamydia trachomatis infections: a systematic review and Meta-analysis

作　　者：滕扬 姜婷婷 尹跃平 王宇萍[1] 陈祥生 Teng Yang;Jiang Tingting;Yin Yueping;Wang Yuping;Chen Xiangsheng(School of Population Medicine and Public Health,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Institute of Dermatology,Chinese Academy of Medical Sciences&Peking Union Medical College National Center for STD Control,China CDC,Nanjing 210042,China)

机构地区：[1]中国医学科学院北京协和医学院群医学及公共卫生学院,北京100730 [2]中国医学科学院皮肤病研究所、中国疾病预防控制中心性病控制中心,南京210042

出　　处：《国际流行病学传染病学杂志》2023年第3期178-184,共7页International Journal of Epidemiology and Infectious Disease

摘　　要：目的系统评价生殖道沙眼衣原体感染的自清除率及其影响因素,为流行病学研究和临床干预提供参考依据。方法在PubMed、Web of Science、中国知网(CNKI)、万方和维普数据库中,系统检索生殖道沙眼衣原体感染自清除相关的文献,时限从建库至2022年6月。按照纽卡斯尔-渥太华量表的评分标准,评价纳入研究的质量。采用RevMan5.4和Stata14.0软件对生殖道沙眼衣原体感染的自清除率进行Meta分析,按照自清除可能的影响因素进行亚组分析。结果最终纳入文献16篇,累计研究对象2530例。Meta分析结果显示,生殖道沙眼衣原体感染的自清除率为37.28%(95%CI:21.24%~53.32%)。男性自清除率为31.79%(95%CI:7.62%~55.96%),低于女性(χ^(2)=83.69,P<0.001);按年龄分组,≤30岁自清除率为38.23%(95%CI:20.17%~56.29%),低于>30岁组(χ^(2)=6.83,P=0.009);按筛查至随访时间分组:<1年自清除率为34.00%(95%CI:21.00%~46.00%),低于≥1年组(χ^(2)=93.24,P<0.001);按感染部位分组:阴道自清除率为36.00%(95%CI:9.00%~63.00%),宫颈为35.00%(95%CI:14.00%~56.00%),尿道为33.00%(95%CI:9.00%~57.00%),3组间差异有统计学意义(χ^(2)=27.72,P<0.001)。结论生殖道沙眼衣原体感染自清除率为37.28%,性别、年龄、随访时间(筛查至随访的时间)和感染部位均会对生殖道沙眼衣原体自清除产生影响。Objective To systematically evaluate the spontaneous clearance rates of genital Chlamydia trachomatis infection and their associated factors in order to provide evidence for epidemiological research and clinical intervention.Methods The literatures related to spontaneous clearance of Chlamydia trachomatis infections were systematically searched in databases of PubMed,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang,and Veep with a time-frame from the establishment of the databases to June 2022.The quality of the included literatures was evaluated according to the Newcastle-Ottawa Scale(NOS).RevMan5.4 and Stata14.0 software were used to perform Meta-analysis of spontaneous clearance of Chlamydia trachomatis infections and subgroup analysis according to potential factors associated to the clearance.Results Sixteen papers with a total of 2530 cases were finally included.Meta-analysis indicated that the overall spontaneous clearance rate of genital Chlamydia trachomatis infection was 37.28%(95%CI:21.24%-53.32%).The spontaneous clearance rate was 31.79%(95%CI:7.62%-55.96%)for males and was lower than females(χ^(2)=83.69,P<0.001);and was 38.23%(95%CI:20.17%-56.29%)for patients≤30 years and was lower than patients>30 years(χ^(2)=6.83,P=0.009);and was 34.00%(95%CI:21.00%-46.00%)for follow-up of<1 year group and was lower than≥1 year group(χ^(2)=93.24,P<0.001).The spontaneous clearance rates in vaginal infection,cervical infection and urethral infection were 36.00%(95%CI:9.00%-63.00%),35.00%(95%CI:14.00%-56.00%)and 33.00%(95%CI:9.00%-57.00%),respectively and the difference was statistically significant.Conclusions The available evidence suggests that the spontaneous clearance rate of genital Chlamydia trachomatis infection is 37.28%,and the gender,age,follow-up time interval and infection site are risk factors for spontaneous clearance of genital Chlamydia trachomatis infection.

关 键 词：沙眼衣原体 自清除率 影响因素 META分析 

分 类 号：R759[医药卫生—皮肤病学与性病学]