| 摘要: |
| 目的 探讨补充叶酸与结直肠腺瘤复发风险的关系。方法 计算机检索Cochrane图书馆临床对照试验资料库、Pubmed、Embase、CBMdisc、CNKI等数据库, 手工检索相关文献, 纳入结直肠腺瘤切除后人群补充叶酸与安慰剂的随机对照研究(RCT)。评价质量及提取资料后, 采用RevMan 5.0.24软件对腺瘤及进展期腺瘤复发风险进行合并。结果 共纳入6项RCT研究, 2 002例患者。分析提示:腺瘤复发风险在补充叶酸与安慰剂之间差异无统计学意义\[RR=0.97, 95% CI(0.79, 1.19), P=0.76\]；而进展期腺瘤的复发风险, 两组间存在统计学差异\[RR=1.33, 95% CI(1.01, 1.74), P=0.04\],该效应在补充叶酸1 mg/d、≥3年时已出现\[RR=1.49, 95%CI(1.07, 2.09), P=0.02\]。结论 补充叶酸未能显示出减少结直肠腺瘤复发风险的作用, 可能增加了进展期腺瘤的复发风险。 |
| 关键词: 结直肠肿瘤 腺瘤 叶酸 复发 Meta分析 |
| DOI：10.3724/SP.J.1008.2010.00 |
| 投稿时间：2010-04-27修订日期：2010-07-21 |
| 基金项目:国家自然科学基金(30771838). |
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| Folic acid supplementation in prevention of colorectal adenoma recurrence: a meta-analysis |
| DENG Shang-xin1, HONG Shang-you1, AN Wei1, GAO Jie1, CAI Quan-cai2*,Cai quancai |
| (2. Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai 200433, China) |
| Abstract: |
| Objective To evaluate the role of folic acid supplementation in prevention of colorectal adenoma recurrence. Methods We conducted computer search of the Cochrane Central Register of Clinical Trails, Pubmed, Embase, CBMdisc and CNKI. Hand search of relevant journals and conference proceedings was also conducted. Based on the predefined inclusion and exclusion criteria, randomized controlled trials(RCT) about folic acid in treatment of patients after adenoma resection were included in the present study. After evaluating the quality of studies, meta-analyses were performed by RevMan 5.0.24 software for the pooled recurrence risks of colorectal adenoma and progressive colorectal adenoma. Results A total of 6 RCT studies, including 2,002 patients, were enrolled in this study. The results of meta-analysis showed that the recurrence risks of colorectal adenomas were not significantly different between folic acid supplementation and placebo groups \[RR=0.97, 95%CI(0.79, 1.19), P=0.76\]; but there were significant differences in the risks of progressive adenomas between the two groups\[RR=1.33, 95%CI(1.01, 1.74), P=0.04\]; and this effect of folic acid supplementation appeared when 1 mg/d folic acid supplementation was applied for ≥3 years \[RR=1.49, 95%CI(1.07, 2.09), P=0.02\]. Conclusion Folic acid supplementation fails to reduce the risk of colorectal adenoma recurrence, and it might increase the recurrence risk of advanced adenoma. |
| Key words: colorectal neoplasms adenoma folic acid recurrence Meta-analysis |
