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中国人群胃食管反流病流行病学的系统评价

发布时间:2018-05-02 16:38

  本文选题:胃食管反流病 + 横断面研究 ; 参考:《上海交通大学》2014年博士论文


【摘要】:目的系统评价中国人群胃食管反流病(GERD)流行病学的临床资料。 方法计算机检索中国生物医学文献数据库、中国全文期刊数据库、中国科技期刊数据库、PubMed电子数据库,入选2013年12月以前公开发表的有关中国人群GERD流行病学的相关文献。对纳入文献进行数据提取和文献质量评估。根据纳入文献中GERD诊断标准进行分组,讨论中国人群GERD患病率情况,并对相关危险因素与GERD之间的相关性进行Meta分析或定性分析。Meta分析中,应用固定效应模型或随机效应模型,以比值比(OR)及其95%可信区间(CI)计算合并效应量,以亚组分析和敏感性分析寻找异质性来源,以漏斗图、Begg秩相关法和Egger直线回归法分析发表性偏倚。 结果24篇文献纳入系统评价,总体方法学质量较好。以每周至少发生一次反流症状作为诊断标准时,GERD患病率为2.5%~6.2%;以蒙特利尔定义作为诊断标准时,GERD患病率为2.8%~8.4%;以胃食管反流性诊断问卷(RDQ)≥12分为诊断标准时,GERD患病率为2.7%~10%;以SGER评分≥6分作为诊断标准,GERD患病率为5.77%~8.68%。Meta分析结果显示,肥胖、饮酒、居住农村地区、油腻饮食、进食过饱、甜食、咖啡、便秘与GERD的发生呈正相关:肥胖1.75(1.51,2.04)、饮酒1.10(1.01,1.20)、农村地区1.39(1.23,1.56)、油腻饮食1.41(1.15,1.71)、进食过饱1.92(1.64,2.25)、甜食1.43(1.15,1.79)、咖啡1.25(1.04,1.50)、便秘1.82(1.44,2.31);性别、吸烟、工作类型、辛辣食物、浓茶与GERD之间无相关性:男性1.13(0.99,1.29)、吸烟1.10(0.86,1.42)、脑力工作0.92(0.68,1.23)、辛辣食物1.10(0.97,,1.26)、浓茶1.17(0.96,1.44)。定性分析结果表明,年龄大、胃肠道疾病家族史、精神状态差、工作压力大、食管裂孔疝、胆汁反流与GERD的发生呈正相关。部分危险因素的Meta分析结果存在发表性偏倚。 结论在中国人群中进行的GERD流行病学调查存在不同的研究设计,各地区GERD患病率有差异,但差异不大,患病率均在10%以下。肥胖、年龄大、居住农村地区、不良生活饮食习惯、胃肠道疾病家族史、精神状态差、工作压力大等因素是GERD的危险因素。
[Abstract]:Objective to evaluate the epidemiological data of gastroesophageal reflux disease (GERD) in Chinese population. Methods Chinese biomedical literature database, Chinese full-text journal database, Chinese sci-tech journal database and PubMed electronic database were searched by computer. The relevant literatures on GERD epidemiology of Chinese population published before December 2013 were selected. Data extraction and document quality evaluation are carried out on the included documents. According to the diagnostic criteria of GERD included in the literature, the prevalence of GERD in Chinese population was discussed, and the fixed effect model or random effect model was used to analyze the correlation between the risk factors and GERD by Meta analysis or qualitative analysis. The combined effects were calculated by ratio OR and 95% CI), heterogeneity sources were found by subgroup analysis and sensitivity analysis, and published bias was analyzed by Begg rank correlation method and Egger linear regression method. Results 24 articles were included in the systematic evaluation, and the overall quality of methodology was good. The prevalence rate of GERD was 2.5 and 6.2 using the reflux symptom at least once a week as diagnostic criterion, the prevalence rate of GERD with Montreal definition as diagnostic criterion was 2.8 and 8.4, and the GERD was divided into diagnostic criteria by RDQ 鈮

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