初潮年龄及术后妊娠分娩次数与子宫肌瘤剔除术后复发关系Meta分析

Relationship of age of menarche and number of motherhood with risk of fibroid recurrence after myomectomy:a meta-analysis

目的系统评价初潮年龄以及术后妊娠分娩次数与子宫肌瘤剔除术后复发关系。方法计算机检索中国知网(CNKI)、万方、维普、中国生物医学文献数据库、Pubmed数据库、Google scholar、Cochrane library和Web of Science数据库中关于初潮年龄、术后妊娠分娩次数与女性子宫肌瘤剔除术后复发危险关系的队列研究,检索时间为建库时间至2016-07-01。按照纳入排除标准筛选文献后提取数据,并按照NOS队列研究质量评价标准进行纳入文献质量评价,使用Stata12.0软件进行统计分析。结果最终27篇文献包括5492例病例纳入研究。初潮年龄<13岁(RR=1.53,95%CI=1.15~2.04)和术后未分娩(RR=1.63,95%CI=1.30~2.03)是术后复发的危险因素;初潮年龄低于14岁(RR=1.23,95%CI=0.86~1.75)和术后妊娠(RR=1.01,95%CI=0.79~1.29)对复发风险无显著影响,按照文献来源进行亚组分析(中文:RR=0.90,95%CI=0.70~1.15;英文:RR=1.39,95%CI=0.74~2.58)也没有发现显著关联。结论初潮年龄<13岁和术后未分娩是子宫肌瘤术后复发的危险因素。

Objective To systematically evaluate the association between menarche age as well as number of motherhood and risk of fibroid recurrence after myomectomy.Methods Cohort studies about the association between menarche age as well as number of motherhood and risk of fibroid recurrence after myomectomy were searched online using CNKI, WanFang, VIP, Chinese biomedical literature database, PubMed, Google scholar, Cochrane library and web of science databases. The data were extracted from the eligible studies which were selected according to the inclusion and exclusion criteria, and then quality evaluation was conducted according to the NOS cohort study quality evaluation criteria. The Stata 12.0 software was used for statistical analysis.Results A total of 27 literatures, including 5492 patients, were included at last in the study. Age of menarche below 13 years old （RR=l.53,95%CI=1.15-2.04）and nulliparous after myomectomy（RR=1.63,95%CI=1.30-2.03） were risk factors for recurrence of uterine neoplasms after myomectomy.However, age of menarche below 14 years old （RR=1.23,95%CI=0.86-1.75） and pregnancy times after myomectomy （RR= 1.01,95%CI=0.79-1.29 ） were not found significantly associated with recurrence risk, even though we carried out a subgroup analysis based on literature language（Chinese： RR=0.90,95%CI=0.70-1.15;English： RR=1.39, 95% C1=0.74-2.58）.Conclusion Menarche age below 13 years old and nulliparous women are risk factors for the recurrence of uterine neoplasms after myomectomy.