本文選題：血清固定 + 梅毒��； 參考：《中國(guó)衛(wèi)生統(tǒng)計(jì)》2014年04期

【摘要】：目的梅毒血清固定潛在的影響因素阻礙其有效防治,對(duì)可能的影響因素進(jìn)行Meta分析,能為其防治提供臨床證據(jù)。方法檢索Pubmed、Google Scholar、CNKI、萬方數(shù)據(jù)庫、重慶維普(VIP)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBMDisc)。納入標(biāo)準(zhǔn):血清固定的診斷標(biāo)準(zhǔn)明確;以梅毒血清固定的影響因素為研究目的;HIV抗體檢測(cè)陰性,女性為非妊娠或哺乳期婦女;研究結(jié)局為血清固定,對(duì)照為血清治愈組或健康對(duì)照組;語種限制為中文和英文。排除標(biāo)準(zhǔn):資料不全或無法獲取全文;重復(fù)報(bào)告;病例報(bào)告;缺乏對(duì)照;與研究目的不符;血清固定治療;梅毒合并HIV;系統(tǒng)綜述。計(jì)數(shù)資料用風(fēng)險(xiǎn)比(RR),計(jì)量資料采用標(biāo)準(zhǔn)化均數(shù)差(SMD)。數(shù)據(jù)的統(tǒng)計(jì)分析采用RevMan 5.1、SAS 9.0軟件。結(jié)果最初共檢索到1129篇文獻(xiàn),最終納入25篇文獻(xiàn),涉及5153例梅毒患者。不同年齡段(RR≥40歲vs≤24歲=2.53,95%CI:1.53~4.19;RR≥40歲vs 25~39歲=1.99,95%CI:1.32~3.01)、性別(RR女vs男=1.5,95%CI:1.26~1.79)、梅毒臨床分期(RR潛伏vs一期=3.34,95%CI:2.71~4.13;RR潛伏vs二期=2.17,95%CI:1.56~3.03)、血清初始滴度(RR1:32 vs≤1:32=0.15,95%CI:0.11~0.20)、治療方式(RR非青霉素vs青霉素=2.20,95%CI:1.12~4.33)血清固定風(fēng)險(xiǎn)存有差異。血清固定患者外周血CD3、CD4、CD8及血清中IL-10水平與健康對(duì)照組和血清治愈組相比存在差異。此外,有文獻(xiàn)提示TP重復(fù)基因型分型(RRi亞型vs d亞型=4.67,95%CI:1.31~16.69)、TP隱匿感染(RRFTA-Abs TP(+)vs FTA-Abs TP(-)=3.27,95%CI:2.89~3.69;RRTPPA-TP(+)vs TPPA-TP(-)=3.26,95%CI:2.89~3.68)可能與梅毒血清固定有關(guān)。結(jié)論至今有關(guān)梅毒血清固定還沒有被廣泛認(rèn)可的確切定義,其機(jī)理也基本不清。年齡越大、女性、潛伏梅毒、血清初始滴度較低、非青霉素治療及機(jī)體細(xì)胞免疫抑制及紊亂可能是梅毒血清固定的危險(xiǎn)因素。梅毒血清固定有效防治策略應(yīng)該針對(duì)潛在的各個(gè)影響因素來制定。
[Abstract]:Objective to provide clinical evidence for the prevention and treatment of syphilis by meta-analysis of the possible influencing factors. Methods We searched Pubmedus Scholararum CNKI, Wanfang database, VIP in Chongqing and CBMDisc in Chinese biomedical literature database. Inclusion criteria: the diagnostic criteria for serum fixation were clear; HIV antibodies were negative and women were non-pregnant or lactating women; serum fixation was the outcome of the study. The control group was serum cured group or healthy control group, and the language limitation was Chinese and English. Exclusion criteria: incomplete or inaccessible data; repeated reports; case reports; lack of control; inconsistent with the purpose of the study; serofixation; syphilis with HIV; systematic review. Risk ratio (RR) and standardized mean difference (SMD) were used for counting data. The data were analyzed by Revman 5.1 SAS 9.0 software. Results A total of 1129 articles were initially retrieved, and 25 papers were included, involving 5153 syphilis patients. Clinical stages of syphilis (RR 鈮，

本文編號(hào)：2109771