饮水型砷中毒患病率与性别差异关联的Meta分析

摘要

Objective To investigate whether there is any correlation between prevalence rate of arseniasis exposure from drinking water and gender differences.Methods Nineteen papers about relation between prevalence rate of arseniasis from drinking water and gender differences published from 1999 to 2016 on this topic were collected,and the data were quantitatively analyzed with random or fixed effect models. The pooled odds ratio and 9 5%CI were calculated,and the published bias was assessed qualitatively by fun-nel plots.Results Meta-analysis showed these papers were inhomogeneous (χ2=261.67,I2=93%,P <0.000 01).Therefore a random effect model was used.The combined OR (OR =1.36;95%CI:1.18-1.57)suggested the prevalence rate of arseniasis in male group was higher than in female group.Due to the Meta analysis results do not met the conditions,funnel plots were not analyzed.Conclusion There were existed correlation between prevalence rate of arseniasis exposure from drinking water and gender differ-ences,and the sensitivity of male were stronger than that of female in terms of arsenic pathogenic damage. gender differences may be a risk factor for male.%目的：探讨不同性别人群饮水型砷中毒患病率是否存在差异。方法检索1999－2016年国内饮水型砷中毒流行病学调查相关文献，行质量评价后按照一定标准筛选文献，纳入与饮水型砷中毒患病性别分布有关的19篇文献，应用固定效应模型或随机效应模型进行综合定量分析，开展合并效应估计值OR及其95％可信区间的估计和倒漏斗图分析。结果经 Meta分析一致性检验，各研究结果存在明显异质性（χ2＝261．67，I2＝93％， P ＜0．00001），支持随机效应模型，其合并效应量OR值及其95％可信区间为1．36[1．18，1．57]。由于结果不满足固定效应模型条件，未进行倒漏斗图分析。Meta分析显示慢性砷暴露下男性砷中毒患病率高于女性。结论高砷病区人群中砷中毒患病率存在性别差异。男性对砷致病损的敏感性强于女性，男性可能是砷暴露人群易患砷中毒的危险因素之一。