溃疡性结肠炎病因的Meta分析

摘要

目的 分析溃疡性结肠炎(UC)发病的相关因素.方法 计算机检索英文数据库PubMed、Cochrane、Embase及中文数据库中国知网(CNKI)、万方数据知识服务平台(Wanfang)、中国生物医学文献服务系统(SinoMed)与维普期刊资源整合服务平台(VIP),纳入2000年1月至2014年10月有关UC病因的相关文献.根据纳入与排除标准筛选文献,提取资料和评价质量后采用Stata 12.0软件进行Meta分析.结果 共纳入24篇文献,合计病例组5 653例,对照组20 218例.Meta分析显示,炎症性肠病家族史、戒烟、胃肠道感染史、经常饮用牛奶、油脂饮食、阑尾切除术、吸烟和接受高等教育与UC发病相关,其OR值(95％CI)分别为4.68(3.59～6.11)、1.81 (1.58 ～2.09)、5.10(2.38～ 10.92)、2.26(1.65 ～ 3.09)、2.21(1.49 ～ 3.27)、0.40(0.32～ 0.51)、0.44(0.32 ～ 0.60)和0.50(0.36～0.69).结论 炎症性肠病家族史、戒烟、胃肠道感染史、经常饮用牛奶和油脂饮食是目前UC的危险因素,而吸烟、阑尾切除术以及接受高等教育为保护因素.%Objective To analyze the main influencing factor of ulcerative colitis (UC).Methods Literature retrieval was conducted by using English databases (PubMed,Cochrane and Embase) and Chinese databases (CNKI,Wanfang,SinoMed and VIP) to collect the studies on the influencing factors of UC published both at home and abroad from January 2000 to October 2014.According to the inclusion and exclusion criteria,data were extracted and methodological quality was assessed.Then,a Meta-analysis was performed with Stata 12.0 software.Results A total of 24 casecontrol studies were included,involving 5 653 patients and 20 218 controls.The results of Meta-analysis showed that the influencing factors of UC would include family history of inflammatory bowel disease,ex-smoker,gastrointestinal infections,regular consumption of milk,fat diet,appendectomy,smoking and high educational level,with the pooled OR values as 4.68 (95％ CI:3.59-6.11),1.81 (95％CI:1.58-2.09),5.10 (95％CI:2.38-10.92),2.26 (95％CI:1.65-3.09),2.21 (95％ CI:1.49-3.27),0.40 (95％ CI:0.32-0.51),0.44 (95％ CI:0.32-0.60) and 0.50 (95％ CI:0.36-0.69),respectively.Conclusion Current evidence showed that the risk factors influencing the incidence of UC were family history of inflammatory bowel disease,ex-smoker,gastrointestinal infections,regular consumption of milk and fat diet,whereas appendectomy,smoking and high educational level were protective factors for UC.