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预防医学  2018, Vol. 30 Issue (4): 382-386    DOI: 10.19485/j.cnki.issn2096-5087.2018.04.016
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再生障碍性贫血发病影响因素的Meta分析
李秋爽1,沈怡雯2,季聪华1,刘姗1,张颖1
1.浙江省中医院临床评价中心,浙江 杭州 310006;
2.浙江中医药大学基础医学院
Risk factors of aplastic anemia:A Meta-analysis
LI Qiu-shuang*,SHEN Yi-Wen,JI Cong-hua,LIU Shan,ZHANG Ying
*The Center of Clinical Evaluation and Analysis of Zhejiang Provincial Hospital of TCM,Hangzhou,Zhejiang 310016,China
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摘要 目的 分析再生障碍性贫血发病的危险因素,为一级预防提供依据。方法 以“再生障碍性贫血”“病例对照研究”“危险因素”等为关键词,检索中国期刊全文数据库、维普中文科技期刊数据库等中文数据库;以“aplastic anemia”“case-control study”“risk factor” 等为关键词,检索PubMed、Cochrane Library等外文数据库,查找关于再生障碍性贫血发病危险因素的相关研究文献,时间范围为建库至2017年9月。采用Stata 14.0 软件进行Meta分析,计算合并OR值。结果 共检索到1 094篇文献,最终纳入22篇文献,均为病例对照研究,共涉及16项危险因素。Meta分析结果显示,油漆接触(OR=3.82,95%CI:1.68~8.66)、氯霉素使用(OR=3.21,95%CI:1.98~5.20)、苯接触(OR=2.94,95%CI:2.11~4.11)、胶水接触(OR=2.56,95%CI:1.28~5.12)、肝炎病史(OR=2.54,95%CI:1.94~3.34)、染发剂接触(OR=2.37,95%CI:1.08~5.22)、农药接触(OR=1.98,95%CI:1.60~2.45)、β-内酰胺(OR=1.77,95%CI:1.03~3.06)、磺胺类(OR=1.64,95%CI:1.03~2.61)和燃料/石油接触(OR=1.53,95%CI:1.25~1.87)等10个因素是再生障碍性贫血发病的危险因素;高经济收入(OR=0.52,95%CI:0.43~0.63)是再生障碍性贫血发病的保护因素。结论 再生障碍性贫血的危险因素主要涉及药物使用、既往史、社会经济地位和职业或环境接触化学毒物等。
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李秋爽
沈怡雯
季聪华
刘姗
张颖
关键词 再生障碍性贫血危险因素Meta分析    
AbstractObjective To comprehensively evaluate the risk factors of aplastic anemia,and provide scientific evidence for the primary prevention of aplastic anemia.Methods The published Papers were searched by“aplastic anemia”“case control study”and“risk factors”as key words collected from Chinese National Knowledge Infrastructure,Chinese VIP journal database,PubMed,Cochrane library and Clinical Trial and other databases,ranged from the creation date of each database to September 2017 .A meta-analysis of studies on risk factors was performed to calculate the pooled odd ratios(ORs)with 95% confidence intervals(CIs)with Software Stata 14.0.Results The database search resulted in the identification of 1,094 articles. After screening,22 case-control studies were included in the study with 16 factors. Ten risk factors were showed statistically significant differences,including paint exposure(OR=3.82,95%CI:1.68-8.66),chloramphenicol(OR=3.21, 95%CI:1.98-5.20),benzene exposure(OR=2.94,95%CI:2.11-4.11),glue exposure(OR=2.56,95%CI:1.28-5.12),history of hepatitis(OR=2.54,95%CI:1.94-3.34),hair dye exposure(OR=2.37,95%CI:1.08-5.22),pesticides exposure(OR=1.98,95%CI:1.60-2.45),β-lactam(OR=1.77,95%CI:1.03-3.06),sulfonamides(OR=1.64,95%CI:1.03-2.61)and fuel/oil exposure(OR=1.53,95%CI:1.25-1.87),and high economic income(OR=0.52,95%CI:0.43-0.63)is the protective factor.Conclusion The meta-analysis of case-control studies suggests that the risk factors of aplastic anemia mainly including four aspects:drug use,past history,socioeconomic status and occupational or environmental exposure to chemical toxic substances.
Key wordsAplastic anemia    Risk factors    Meta-analysis
     出版日期: 2018-03-26
ZTFLH:  R556.5  
基金资助:浙江省教育厅科研项目(Y201636810);浙江省中医药科学研究基金项目(2016ZA062)
通信作者: 季聪华,E-mail:jchi_2005@163.com   
作者简介: 李秋爽,硕士,助理研究员,主要从事中医临床科研方法学和循证医学研究工作
引用本文:   
李秋爽,沈怡雯,季聪华,刘姗,张颖. 再生障碍性贫血发病影响因素的Meta分析[J]. 预防医学, 2018, 30(4): 382-386.
LI Qiu-shuang*,SHEN Yi-Wen,JI Cong-hua,LIU Shan,ZHANG Ying. Risk factors of aplastic anemia:A Meta-analysis. Preventive Medicine, 2018, 30(4): 382-386.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2018.04.016      或      http://www.zjyfyxzz.com/CN/Y2018/V30/I4/382
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