牙周炎和先兆子痫相关性的Meta分析

Association between periodontitis and preeclampsia:a Meta-analysis

目的采用Meta分析的方法评价牙周炎和先兆子痫（preeclampsia，PE）之间的关系。方法计算机检索EMBASE、PubMed、CNKI、万方和CBM数据库，检索时限均为从建库至2015年10月31日，同时追查已纳入文献的参考文献。由2位研究者按照纳入和排除标准筛选文献、提取资料并评价质量后，采用RevMan5.3软件进行Meta分析。结果最终纳入13个研究，其中12个是病例—对照研究，1个为队列研究。合计5744例患者，其中PE组1248例，非PE组4496例。Meta分析结果显示：暴露于牙周炎的孕妇发生PE的风险增加2.67倍（OR=2.67，95%CI=1.56～4.57，P＜0.001），按牙周炎定义指标不同亚组分析显示，无论牙周炎按照牙周袋探诊深度（pocketprobingdepth，PPD）、附着丧失（clinicalattachmentlevel，CAL）和探诊出血（bleedingonprobing，BOP）（OR=2.91，95％CI=2.05～4.11，P＜0.001）定义、PPD和BOP（OR=2.33，95％CI=1.28～4.26，P=0.006）定义、PPD和CAL（OR=2.8，95％CI=1.11～7.09，P=0.03）定义，牙周炎均为增加PE发生的危险因素。敏感性分析结果显示稳健性较好。未检测到明显发表偏倚。结论牙周炎是PE发生发展的有意义的危险因素。

Objective To explore the relationship between periodontitis and preeclampsia (PE) using Meta?analysismethod. Methods The EMBASE, PubMed, CNKI, WanFang and CBM databases were searched up to Oct. 31, 2015,and the relevant references of the included studies were also retrieved manually. The literatures were screened accord?ing to the inclusion and exclusion criterias by 2 reviewers independently. The methodology quality was evaluated afterdata abstraction. RevMan 5.3 software was used for Meta?analyses. Results 13 studies consist of 12 case?control stud?ies and 1 cohort study were included. A total of 5 744 patients were involved, with 1 248 preeclampsia (PE) patientsand 4 496 non PE patients. Meta?analysis showed that periodontitis increased the risk of PE with 2.67 times (OR =2.67, 95%CI = 1.56?4.57, P<0.001). 3 subgroups of periodontitis were defined by pocket probing depth (PPD), clini?cal attachment level (CAL), and bleeding on probing (BOP), or by PPD with BOP, or by PPD. 3 subgroup analysis all re?vealed periodontitis was a risk factor, and the OR values were 2.91(95%CI = 2.05?4.11, P<0.001), 2.33(95%CI = 1.28?4.26, P = 0.006) and 2.8 (95%CI = 1.11?7.09, P = 0.03) respectively. Sensitivity analysis showed the results was sta?ble and no publication bias was detected. Conclusion Periodontitis is a significant risk factor in PE according to thisMeta analysis.