中国人群卵巢早衰影响因素的Meta分析

发布时间：2019-01-06 16:49

【摘要】：目的采用Meta分析的方法综合评价中国人群卵巢早衰发病的危险因素和保护因素,并得出其关联强度,为POF疾病的预防提供科学依据,为进一步病因研究提供线索。方法通过计算机检索Pub Med/MEDLINE、Embase、OVID、CBM、CNKI、万方等数据库,收集从2000年1月到2016年10月已发表的关于中国人群卵巢早衰的文献,研究类型为病例对照研究,语种为中文或英文。根据制定的文献纳入和排除标准筛选文献,用Meta分析方法进行综合分析,效应量指标选用OR值和95%CI,采用Stata12.0软件进行异质性检验、敏感性分析和发表偏倚的评估。结果最终纳入27篇病例对照文献,累计病例3249例,对照3119例。进行Meta分析结果如下:1 POF的危险因素及其关联强度:家族史(OR=3.64)、腮腺炎病史(OR=7.71)、免疫性疾病史(OR=6.10)、盆腔炎病史(OR=2.67)、盆腔手术史(OR=4.92)、口服避孕药(OR=4.17)、服用免疫类药物(OR=3.86)、人工流产史(OR=3.68)、盆腔X线照射(OR=2.93)、月经不规律(OR=8.88)、离异或丧偶(OR=3.06)、吸烟(OR=4.38)、接触有毒物质(OR=4.28)、节食减肥(OR=4.17)、染发(OR=3.91)、睡眠质量差(OR=2.75)、饮酒(OR=2.64)、精神创伤或异常(OR=8.60)、不良情绪(OR=5.30)、A型性格行为(OR=3.99)、生活压力大(OR=2.72)、人际关系差(OR=1.59)。2 POF的保护因素及其关联强度:心情愉悦(OR=0.18)、食用蔬菜(OR=0.33)、体育锻炼(OR=0.36)、食用豆制品(OR=0.63)。3生育史、月经初潮早和美容三个因素的合并结果无统计学意义(P0.05),其与POF发病的关系尚不能确定。4敏感性分析结果显示,异质性较大的因素I2值有不同程度的降低,但月经不规律、生育史、美容、体育锻炼和食用豆制品五个因素的异质性仍较高。按剔除单因素作为条件进行敏感性分析结果提示果提示体育锻炼单因素和多因素分析结果不一致,其余因素结果基本一致。5各研究因素经Egger’s法评估发表偏倚,发现食用豆制品因素可能存在发表偏倚。结论1 POF的危险因素有POF家族史、腮腺炎病史、免疫性疾病史、盆腔炎病史、盆腔手术史、口服避孕药、服用免疫类药物、人工流产史、盆腔X线照射、离异或丧偶、吸烟、接触有毒物质、节食减肥、染发、睡眠质量差、饮酒、精神创伤或异常、不良情绪、A型性格行为、生活压力大、人际关系差。POF的保护因素有心情愉悦和食用蔬菜。2月经不规律、月经初潮早、生育史、美容、体育锻炼和食用豆制品六个研究因素与POF发病的关系尚不能确定,需更多数据进一步探讨。3临床上可以应用这些结论指导妇女健康教育,从而预防或延缓POF的发生和发展。
[Abstract]:Objective to evaluate the risk factors and protective factors of premature ovarian failure (POF) in Chinese population by means of Meta analysis, and to obtain its association strength, so as to provide scientific basis for the prevention of POF disease and provide clues for further etiological study. Methods Pub Med/MEDLINE,Embase,OVID,CBM,CNKI, Wanfang database was searched by computer to collect the published literatures on premature ovarian failure in Chinese population from January 2000 to October 2016. The type of study was a case-control study. The language is Chinese or English. According to the criteria of inclusion and exclusion, the comprehensive analysis was carried out by using Meta analysis method. The OR value and 95% CI were selected as the index of effect quantity, and the heterogeneity test, sensitivity analysis and publication bias evaluation were carried out by Stata12.0 software. Results 3249 cases and 3119 cases were included in 27 case-control literatures. The results of Meta analysis were as follows: 1 the risk factors and their association strength of POF: family history (OR=3.64), history of mumps (OR=7.71), history of immunological diseases (OR=6.10), history of pelvic inflammatory disease (OR=2.67). History of pelvic surgery (OR=4.92), oral contraceptive (OR=4.17), taking immunopharmaceuticals (OR=3.86), history of induced abortion (OR=3.68), pelvic X-ray irradiation (OR=2.93), irregular menstruation (OR=8.88), Divorced or widowed (OR=3.06), smoking (OR=4.38), exposure to toxic substances (OR=4.28), dieting (OR=4.17), hair dyeing (OR=3.91), poor sleep quality (OR=2.75), drinking (OR=2.64), Traumatic or abnormal (OR=8.60), bad mood (OR=5.30), A personality behavior (OR=3.99), OR=2.72), OR=1.59. 2 the protective factors and their association strength of POF: OR=0.18, eating vegetables (OR=0.33), physical exercise (OR=0.36), eating soybean products (OR=0.63). 3 reproductive history. The combined results of the three factors of menarche and beauty were not statistically significant (P0.05), and the relationship between them and the onset of POF was uncertain. 4 the sensitivity analysis showed that the I2 value of the heterogeneity factor was decreased in varying degrees. But the heterogeneity of irregular menstruation, birth history, beauty, physical exercise and edible soybean products is still high. The results of sensitivity analysis under the condition of eliminating single factor indicated that the results of single factor exercise and multivariate analysis were inconsistent, and the results of other factors were basically consistent. 5 the publication bias was evaluated by Egger's method. It was found that there might be publication bias in edible soybean products. Conclusion 1 the risk factors of POF include family history of POF, history of mumps, history of immunological diseases, history of pelvic inflammatory disease, history of pelvic surgery, oral administration of contraceptive, taking of immune drugs, history of induced abortion, pelvic X-ray irradiation, divorce or widowhood, smoking. Exposure to toxic substances, diet, weight loss, hair dye, poor sleep quality, alcohol consumption, trauma or abnormality, bad mood, type A personality, high stress in life, Poor interpersonal relationships. The protective factors of POF are pleasure and eating vegetables, irregular menstruation, early menarche, birth history, beauty, physical exercise and eating soybean products. These conclusions can be used to guide women's health education in order to prevent or delay the occurrence and development of POF.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.75

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