循证医学
循證醫學
순증의학
THE JOURNAL OF EVIDENCE-BASED MEDICINE
2009年
5期
287-291,298
,共6页
肝癌%肝炎%乙型%饮酒%饮水%黄曲霉毒素%Meta分析%风险评价
肝癌%肝炎%乙型%飲酒%飲水%黃麯黴毒素%Meta分析%風險評價
간암%간염%을형%음주%음수%황곡매독소%Meta분석%풍험평개
liver cancer%hepatitis B%alcohol drink%water drinking%aflatoxin%meta-analysis%risk assessment
目的 为评价人群患肝癌的风险,用Meta分析方法计算肝癌主要危险因素--乙肝病史、饮酒、饮用不洁水和经常食用黄曲霉毒素污染食物的综合危险度,并建立综合风险评价模型.方法 在PubMed和CBMDisc电子数据库中检索并通过电子检索和手工查阅的方式获得符合纳入标准的文章共34篇,计算各因素的合并效应综合危险度.结果 以社区人群为对照的文献显示乙肝对肝癌发生的综合危险度为6.66[95%可信区间(5.57,7.97)];而以医院人群为对照文献的综合危险度高达25.09[95%可信区间(18.59,33.86)];饮酒、饮用不洁水和经常食用黄曲霉毒素污染食物的综合危险度分别为2.14[95%可信区间(1.97,2.34)]、1.39[95%可信区间(1.17,1.65)]和1.36[95%可信区间(1.13,1.64)].结论 综合风险评价模型可以根据社区个体的生活习惯和疾病史等情况评价个人患肝癌风险的大小,据此可给予其个性化的筛查方案,这将大大提高肝癌筛查的效率和成本效果.
目的 為評價人群患肝癌的風險,用Meta分析方法計算肝癌主要危險因素--乙肝病史、飲酒、飲用不潔水和經常食用黃麯黴毒素汙染食物的綜閤危險度,併建立綜閤風險評價模型.方法 在PubMed和CBMDisc電子數據庫中檢索併通過電子檢索和手工查閱的方式穫得符閤納入標準的文章共34篇,計算各因素的閤併效應綜閤危險度.結果 以社區人群為對照的文獻顯示乙肝對肝癌髮生的綜閤危險度為6.66[95%可信區間(5.57,7.97)];而以醫院人群為對照文獻的綜閤危險度高達25.09[95%可信區間(18.59,33.86)];飲酒、飲用不潔水和經常食用黃麯黴毒素汙染食物的綜閤危險度分彆為2.14[95%可信區間(1.97,2.34)]、1.39[95%可信區間(1.17,1.65)]和1.36[95%可信區間(1.13,1.64)].結論 綜閤風險評價模型可以根據社區箇體的生活習慣和疾病史等情況評價箇人患肝癌風險的大小,據此可給予其箇性化的篩查方案,這將大大提高肝癌篩查的效率和成本效果.
목적 위평개인군환간암적풍험,용Meta분석방법계산간암주요위험인소--을간병사、음주、음용불길수화경상식용황곡매독소오염식물적종합위험도,병건립종합풍험평개모형.방법 재PubMed화CBMDisc전자수거고중검색병통과전자검색화수공사열적방식획득부합납입표준적문장공34편,계산각인소적합병효응종합위험도.결과 이사구인군위대조적문헌현시을간대간암발생적종합위험도위6.66[95%가신구간(5.57,7.97)];이이의원인군위대조문헌적종합위험도고체25.09[95%가신구간(18.59,33.86)];음주、음용불길수화경상식용황곡매독소오염식물적종합위험도분별위2.14[95%가신구간(1.97,2.34)]、1.39[95%가신구간(1.17,1.65)]화1.36[95%가신구간(1.13,1.64)].결론 종합풍험평개모형가이근거사구개체적생활습관화질병사등정황평개개인환간암풍험적대소,거차가급여기개성화적사사방안,저장대대제고간암사사적효솔화성본효과.
Objective To evaluate the risk of liver cancer, meta-analysis was used to estimate synthetical OR (odds ratio) of main risk factors of liver cancer, including hepatitis B, alcohol drinking, rude water drinking and regularly taking aflatexin contaminated food. A synthetical hazard evaluation model was built up. Methods By electronic search of databases included PubMed and CBMDisc as well as manual search in the campus library, a total of 34 papers met the including criteria. The pooled estimation of OR was calculated for each risk factor. Results OR of hepatitis B infection was respectively 6.66 (95%CI 5.57～7.97) and 25.09 (95%CI 18.59～33.86) for studies using community control and hospital control. ORes of alcohol drinking, rude water drinking and regularly taking aflatoxin contaminated food were 2.14 (95%CI 1.97～2.34), 1.39 (95%CI 1.17～1.65), and 1.36(95%CI 1.13～1.64) respectively. An integrated risk evaluation model was built up. Conclusion The integrated model can be used to assess individual hazard of liver cancer according to one's disease history and living habits. The findings contribute to the design of individualized screening protocol, hence to improve the efficiency and cost-effectiveness of screening for liver cancer.
