一项针对我国急性胰腺炎常见病因的Meta分析

A Meta-analysis of aetiology in acute pancreatitis about Chinese clinical trials

目的 了解我国急性胰腺炎（AP）常见病因的特点及其与性别及病死率之间的关系.方法 通过中国期刊全文数据库、万方数据库、维普数据库等数据库及论文集检索相关文献.依据检索策略收集资料,按纳入标准筛选文献,主要对胆源性、高脂血症性、酒精性等引起的AP从性别及病死率方面进行Meta分析.结果 共纳入符合标准的11篇临床研究,涉及13 601例患者,其中胆源性AP6 732例,高脂血症性AP 1 372例,酒精性AP l 169例.Meta分析结果显示：胆源性AP男女比例为0.79∶1,高脂血症性AP男女比例为1.54∶1,酒精性AP男女比例为10.47∶1,暴饮暴食性AP男女比例为1.29∶1,且差异均有统计学意义（P＜0.05）.酒精性AP病死率最高,是胆源性AP病死率的2.81倍,是高脂血症性AP病死率的2.46倍,且差异有统计学意义（P＜0.05）.结论 我国AP常见病因中,胆道疾病仍是主要病因,且女性略高一些,而其他常见病因中男性普遍高于女性.酒精性AP尤为突出,且酒精性AP病死率最高,但仍需要大规模的流行病学研究进一步证实.

Objective To understand the characteristics of common causes of acute pancreatitis （AP） in China and evaluate the association of the aetiology with gender and mortality.Methods The relevant literature was searched by the China journal full-text database （CNKI）,Wanfang database,Weipu database and other databases and proceeding.Based on collecting data retrieval strategy,according to the inclusion criteria selection literature,Meta analysis was performed mainly for gallstone,hyperlipidemia,alcohol and other AP from the aspects of gender and case fatality rate.Results The Meta analysis included 11 articles which were accordance with the criteria,involving 13 601 patients,including 6 732 cases of biliary AP,1 372 cases of hyperlipidemia AP and 1 169 cases of alcohol AP.The Meta analysis showed that biliary AP male to female ratio was 0.79 ∶ 1,hyperlipidemic AP male to female ratio was 1.54 ∶ 1,alcoholic AP male to female ratio was 10.47 ∶ 1,overeating AP male to female ratio was 1.29 ∶ 1,and there was significant difference （P ＜ 0.05）.Alcoholic AP mortality rate was the highest,which was 2.81 times than the biliary AP and 2.46 times than the hyperlipemic AP,and there was significant difference （P ＜0.05）.Conclusions Biliary tract disease is the main etiologic cause of AP in China,and there are more females than males.The mortality rate of alcoholic pancreatitis is the highest,and there are more males.But we should investigate further high-quality,large-scale trails in patients with AP.