卵巢早衰危险因素的Meta分析

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目的:探讨卵巢早衰(premature ovarian failure,POF)的危险因素,为该病的防治提供依据。方法:运用Meta分析对国内、外发表的11篇关于POF的病例对照研究资料进行定量综合分析;采用Stata11.0软件对所选的因素进行异质性检验、合并OR值及95%CI。结果:与POF有关的因素主要包括遗传因素(家族史);医源性因素(盆腔手术史、腹部及盆腔X线照射);感染因素(腮腺炎病史);饮食生活习惯(吸烟、饮酒、经常食用蔬菜、经常食用豆制品、染发);心理因素(心情);月经、婚育史(月经初潮早、离异或丧偶、口服避孕药、人工流产次数)。各因素合并OR值及95%CI分别为吸烟1.97(1.56,2.48)、盆腔手术史3.88(2.77,5.42)、腮腺炎病史8.77(1.62,47.40)、离异或丧偶2.15(1.07,4.32)、经常食用蔬菜0.54(0.42,0.70)、饮酒2.19(1.36,3.55)、人工流产次数1.52(1.23,1.89)、经常食用豆制品0.65(0.25,1.66)、心情0.16(0.11,0.24)、口服避孕药2.47(0.97,6.27)、月经初潮早1.38(0.59,3.21)、家族史4.46(1.89,10.53)、腹部及盆腔X线照射2.92(1.88,4.54)、染发3.56(2.01,6.31)。结论:经常食用蔬菜和心情好是卵巢早衰的保护因素;经常食用豆制品、口服避孕药及月经初潮早与POF的关联无统计学意义;其余均为危险因素。 Objective: To explore the risk factors of premature ovarian failure (POF) and provide basis for the prevention and treatment of the disease. Methods: Meta-analysis was used to quantitatively analyze 11 case-control study data of POF published both at home and abroad. The data were analyzed by using Stata11.0 software, and the OR and 95% CI were combined. Results: The main factors related to POF were genetic factors (family history), iatrogenic factors (history of pelvic surgery, abdomen and pelvic X ray), infectious factors (mumps history), dietary habits (smoking, drinking, regular Edible vegetables, regular consumption of soy products, hair); psychological factors (mood); menstruation, marriage and childbearing history (early menarche, divorced or widowed, oral contraceptives, the number of induced abortion). The combined OR and 95% CI of all factors were 1.97 (1.56, 2.48), 3.88 (2.77, 5.42), mumps history 8.77 (1.62, 47.40), divorced or widowed 2.15 (1.07, 4.32) Consumption of vegetables 0.54 (0.42,0.70), drinking 2.19 (1.36,3.55), the number of abortion 1.52 (1.23,1.89), regular consumption of soy products 0.65 (0.25,1.66), mood 0.16 (0.11,0.24), oral contraceptives 2.47 (0.97, 6.27), 1.38 (0.59, 3.21) respectively, family history 4.46 (1.89, 10.53), abdominal and pelvic X-ray 2.92 (1.88,4.54), and hair 3.56 (2.01,6.31). Conclusion: Regular consumption of vegetables and good mood are the protective factors of premature ovarian failure; regular consumption of soy products, oral contraceptives and early menstruation associated with POF was not statistically significant; the rest were risk factors.
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