口服避孕药与克罗恩病患病风险相关性的Meta分析

    Association of Oral Contraceptive and Risk of Crohn’s Disease: A Meta-Analysis

    • 摘要: 目的 评价口服避孕药与克罗恩病患病风险的相关性。 方法 计算机检索PubMed、EMBASE、中国知网和万方医学网数据库,查找关于口服避孕药与克罗恩病相关性的队列研究或病例对照研究,检索时间均为从建库至2017年11月10日。由两位研究者分别严格按照纳入与排除标准筛选文献、提取资料并评价文献质量,采用Stata 13.0软件进行Meta分析。 结果 最终共纳入17篇文献,累计样本量共308 747例。Meta分析结果显示,口服避孕药可增加克罗恩病患病风险比值比=1.42,95%可信区间(1.24,1.61),P < 0.001,现在使用口服避孕药发生克罗恩病的风险比值比=2.07,95%可信区间(1.27,3.38),P = 0.004高于曾经使用口服避孕药比值比=1.36,95%可信区间(1.07,1.74),P = 0.027。 结论 口服避孕药可增加克罗恩病的患病风险,现在使用组较曾经使用组发病风险增加,但所纳研究缺乏足够使用时间及剂量相关数据,未能进行时间-效应和剂量-效应关系的探究。

       

      Abstract: Objective To explore the correlation between the oral contraceptives(OCs) and the risk of Crohn’s disease (CD). Methods Databases including PubMed, EMBASE, CNKI and Wanfang data were searched from inception to November 10,2017 to collect the cohort studies and case-control studies on the correlation between oral contraceptives and the risk of Crohn’s disease. The studies were screened according to the inclusion and exclusion criteria by two researchers independently, the data was extracted and the quality was evaluated. Meta-analysis was performed using Stata 13.0 software. Results A total of 17 literatures involving 308 747 participants were included. The results of meta-analysis showed that the pooled OR for the risk of CD for women taking the OCs was 1.4295%CI(1.24,1.61),P<0.001, in the subgroup analysis,the OR for the risk of CD in women currently taking the OCs was 2.0795%CI (1.27,3.38),P=0.004, and 1.1795%CI(1.07,1.74),P=0.027 for women used in the past. Conclusion This study provides evidence of an association between the use of oral contraceptives and the onset risk of CD. The study also showed that the risk for patients who stop using the OCs decreased. But the study did not find time-effect relationship or dose-effect relationship for lack of sufficient data.

       

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