处方激素避孕与多发性硬化症风险之间的关联:系统性审查和元分析
Jessica McDonald1, Priya Sharma1, Christopher Tench1
1Mental Health and Clinical Neuroscience Unit, School of Medicine, University of Nottingham, Nottingham, UK.
女性使用荷尔蒙避孕药似乎不会显著增加多发性硬化症 (MS) 风险. 需要进一步的高质量研究来证实这种关联,因为当前研究中的异质性很高.
科学领域:
- 神经学 神经学
- 内分泌学 在内分泌学.
- 流行病学 流行病学
背景情况:
- 性激素在多发性硬化症 (MS) 易感性中起作用.
- 荷尔蒙避孕药 (HC) 在全球范围内被广泛使用.
- 关于HC使用和MS风险的现有证据仍然没有确定性.
研究的目的:
- 综合现有研究关于使用处方激素避孕药与患多发性硬化症的风险之间的关联.
- 提供当前证据库的全面概述.
主要方法:
- 在Medline,Embase,Cochrane图书馆和灰色文学中进行系统的文献搜索.
- 独立的数据提取和质量评估由两个审查员使用乔安娜·布里格斯研究所的标准.
- 对调整和未调整的赔率比率进行随机效应元分析,对高质量的研究进行敏感性分析.
主要成果:
- 包括11项研究 (六个队列,五个病例控制);只有三项是高质量的.
- 未经调整的元分析表明MS风险增加 (OR 1.28),但调整后的分析和灵敏度分析显示没有显著的关联.
- 五项研究没有发现显著的关联,四项研究表明风险降低,两项研究表明风险增加.
结论:
- 在使用荷尔蒙避孕药与多发性硬化症风险之间没有观察到统计学意义上的关联.
- 高异质性和有限的高质量研究需要进一步的精心设计的研究.
- 潜在的风险增加需要继续调查.
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