【摘要】：目的系統(tǒng)評(píng)價(jià)出生體重與慢性腎臟病風(fēng)險(xiǎn)的關(guān)聯(lián)性。方法電子檢索The Cochrane圖書館、MEDLINE、OVID數(shù)據(jù)庫、Springer數(shù)據(jù)庫、維普數(shù)據(jù)庫、萬方數(shù)據(jù)庫和中國(guó)知網(wǎng),檢索時(shí)間為建庫截止至2016年6月,納入以BW為暴露因素、評(píng)估生后發(fā)生CKD或其相關(guān)結(jié)局變量的觀察性研究,文獻(xiàn)需對(duì)CKD或其他結(jié)局變量的診斷標(biāo)準(zhǔn)做出描述并能提取CKD或其相關(guān)結(jié)局變量的OR值及其95%CI,語種限定為中、英文;排除文獻(xiàn):研究對(duì)象生后12個(gè)月內(nèi)腎功能衰竭和死亡、有宮內(nèi)感染病史或患先天遺傳性疾病,母孕期暴露因素有潛在毒性物質(zhì)接觸史,研究人群包括成人和兒童但無法單獨(dú)提取兒童數(shù)據(jù)。由兩位作者獨(dú)立檢索關(guān)于出生體重(BW)對(duì)CKD風(fēng)險(xiǎn)相關(guān)的觀察性研究,病例對(duì)照和隊(duì)列研究采用NOS量表、橫斷面研究采用AHRQ量表對(duì)文獻(xiàn)進(jìn)行偏倚風(fēng)險(xiǎn)評(píng)價(jià),提取OR值和95%CI。應(yīng)用Stata 12.0對(duì)文獻(xiàn)進(jìn)行Meta分析,均選用Der SimonianLaird隨機(jī)效應(yīng)模型分析。結(jié)果 10篇觀察性研究納入本文分析,其中病例對(duì)照4篇(3篇8分,1篇7分),隊(duì)列研究4篇(3篇7分,1篇8分),橫斷面研究2篇(1篇7分,1篇8分)。慢性腎臟病風(fēng)險(xiǎn)低出生體重(LBW)較正常BW人群高約80%,OR=1.80,95%CI:1.37~2.35;其中蛋白尿、終末期腎臟病和低e GFR在LBW較正常BW人群的OR及其95%CI分別為2.58(1.49~4.46)、1.42(1.22~1.66)和1.87(1.19~2.94)。終末期腎臟病、低e GFR在高出生體重(HBW)中較正常BW人群的OR及其95%CI分別為1.19(0.94~1.49)和1.09(0.93~1.27),HBW與生后慢性腎臟病之間無明顯關(guān)聯(lián);LBW人群作為慢性腎臟病的高危人群僅見于男性人群中,OR=1.83,95%CI:1.10~3.05)。Egger回歸提示納入文獻(xiàn)不存在發(fā)表偏倚。結(jié)論男性LBW是CKD的高危因素,HBW與生后CKD的發(fā)生無明顯關(guān)聯(lián)。
[Abstract]:Objective to evaluate the relationship between birth weight and risk of chronic kidney disease. Methods The Cochrane library was searched with MEDLINE OVID database, Springer database, Weip database, Wanfang database and China knowledge network. The retrieval time was up to June 2016, and BW was included as the exposure factor. To evaluate the observational study of postnatal CKD or its related outcome variables, the literature should describe the diagnostic criteria of CKD or other outcome variables and extract the OR values of CKD or its related outcome variables and 95 CIs in Chinese and English. Excluded documents: the subjects had a history of intrauterine infection or congenital hereditary disease, and exposure factors during pregnancy had a history of exposure to potentially toxic substances, including renal failure and death within 12 months after birth. The study included adults and children but could not extract data on children alone. The two authors independently searched for an observational study on the relationship between birth weight (BW) and CKD risk, case control and cohort studies using NOS scale, cross-sectional study using AHRQ scale to evaluate the bias risk of literature, and extracting OR value and 95 CIs. Stata 12.0 was applied to the Meta analysis of the literature, and Der SimonianLaird random effect model was used to analyze the results. Results Ten observational studies were included in this study, including 4 case control papers (3 8 points, 1 7 points), 4 cohort studies (3 papers 7 points, 1 article 8 points) and 2 cross-sectional studies (1 paper, 7 points, 1 article, 8 points). The risk of chronic kidney disease in low birth weight (LBW) was about 80% higher than that in normal BW group, and the OR and 95%CI in LBW group were 1.42 (1.221.66) and 1.87 (1.192.94), respectively, of which proteinuria, end-stage kidney disease and low e GFR were 1.42 (1.221.66) and 1.87 (1.192.94) respectively. End stage kidney disease, The OR and 95%CI of low e GFR in (HBW) with high birth weight were 1.19 (0.94 鹵1.49) and 1.09 (0.933 鹵1.27) respectively. There was no significant correlation between OR and chronic renal disease. The high risk group of chronic kidney disease was only found in male population (1.8395CIW 1.103.05) .Egger regression was reported. There was no publication bias in the literature. Conclusion there is no significant correlation between male LBW and postnatal CKD.
【作者單位】： 中南大學(xué)湘雅二醫(yī)院兒科;
【分類號(hào)】：R722.1

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