子宫内膜异位症发病危险因素meta分析

Risk factors for endometriosis:a meta-analysis

目的:运用系统评价方式探讨子宫内膜异位症(EMs)发病的危险因素,为EMs病因诊断提供循证医学依据。方法:计算机检索中国知网(CNKI)、中国生物医学文献(CBM)、万方、PubMed、Embase、Medline等数据库,检索词包括“子宫内膜异位症”、“危险因素”、“病例对照研究”、“队列研究”主题词及相关自由词,收集2010年至2021年发表的相关文献,采用Cochrane图书馆数据库提供的RevMan5.4对EMs的发病危险因素进行meta分析。结果:10篇文献符合纳入标准,累计病例数和对照数分别为4660例和78785例。Meta分析结果显示,EMs的危险因素为人工流产或子宫腔内操作(OR=3.43,95%CI为1.63~7.23),保护性因素为既往妊娠(OR=0.55,95%CI为0.38~0.79)。结论:人工流产或子宫腔内操作是EMs的独立危险因素,既往妊娠为保护性因素,可为临床中的鉴别诊断提供参考。

Objective:To explore the risk factors of endometriosis by means of systematic evaluation,and to provide evidence for the prevention of endometriosis.Methods:The literatures published from 2010 to 2021 were searched in CNKI,CBM,Wanfang Database,PubMed Database,Embase Database,Medline Document Service,et al."Endometriosis","risk factors","case-control study","cohort study"and their free words were selected as keywords.The literatures were evaluated by Newcastle-Ottawa Scale.The meta-analysis were performed in the literatures scored above 6.Result:A total of 10 articles were included in the meta-analysis with the cumulative number of cases and controls reaching 4660 and 78785 respectively.Meta-analysis showed that the risk factor for endometriosis was artificial abortion or intrauterine medical intervention(OR=3.43,95%CI:1.63~7.23),protective factor was parity(OR=0.55,95%CI:0.38~0.79).Conclusion:Artificial abortion or intrauterine medical intervention is an independent risk factor for endometriosis.Meanwhile,number of pregnancy was found to be a protective factor in the study.