膝骨关节炎危险因素的系统评价与Meta分析

Risk Factors for Knee Osteoarthritis: a Systematic Review and Meta-analysis

中文关键词: 骨关节炎  膝  危险因素  Meta分析

英文关键词: Osteoarthritis  Knee  Risk factors  Systematic review  Meta-analysis

中文摘要:

      目的 探讨膝骨关节炎发生的危险因素,为膝骨关节炎的防治提供科学依据.方法 计算机检索有关膝骨关节炎危险因素病例对照研究的英文文献,根据纳入与排除标准筛选文献,并提取资料,进行质量评价,用RevMan5.3软件进行Meta分析.结果 体质指数≥25 kg/m2、膝关节损伤史、职业运动锻炼、重体力职业、遗传、糖尿病是膝骨关节炎的危险因素,OR值及95％CI分别为3.39 (2.86～4.03)、2.82 (1.97～4.04)、1.31 (1.11～1.55)、1.75(1.55～ 1.99)、2.18 (1.90～2.51)、1.47 (1.12～1.92).低强度活动锻炼和吸烟是膝骨关节炎的保护因素,其OR值及95％CI为0.67 (0.54～0.83)、0.68 (0.56～0.82).负重、饮酒和雌激素类药物使用史与膝骨关节炎的关系尚不明确,有待进一步研究.结论 控制和减轻体重,避免关节损伤,减少重体力劳动,减少职业运动锻炼,积极治疗糖尿病,适当进行低强度活动锻炼,如散步、骑自行车等,以减少膝骨关节炎的发生.

英文摘要:

      Objective To discuss the risk factors for knee osteoarthritis (KOA).Methods A computer retrieval was made to literature in English on case-control studies of risk factors for information extraction and Meta analysis was applied in quality assessment by Revman 5.3 software.Results The risk factors for KOA included:body mass index (BMI) ≥25 kg/m2 (OR=3.39,95％ CI 2.86～4.03),knee joint injury history (OR=2.82,95％ CI 1.97～4.04),occupational sport training (OR =1.31,95 ％ CI 1.11 ～ 1.55),heavy occupational physical activities (OR =1.75,95 ％ CI 1.55 ～ 1.99),family history (OR=2.18,95％ CI 1.90～2.51) and diabetes (OR=1.47,95％ CI 1.12～ 1.92) while the protective factors for KOA were low intensity exercise (OR=0.67,95％ CI 0.54～0.83) and smoking (OR=0.68,95％ CI 0.56～0.82);the relationship between KOA and weight loading,drinking and estrogen application remained unclear and needed further study.Conclusions It is of help in reducing the occurrence of KOA to control and lose body weight,avoid knee joint injury,reduce intensive heavy labor and occupational sport training,control blood sugar and take low intensive exercise.