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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RevMan5.0.24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,2002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1mg/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。
Objective To investigate the relationship between the folic acid supplement and the risk of recurrent colorectal adenoma. Methods The Cochrane Central Register of Controlled Trials Database, Pubmed, Embase, CBMdisc, CNKI and other databases were searched by computer. A randomized controlled study (RCT) of folic acid supplementation with placebo in patients with colorectal adenoma was included. After evaluating the quality and extracting data, the risk of recurrence of adenoma and advanced adenoma was merged by using RevMan 5.0.24 software. Results A total of six RCTs were included in the study, of which 2002 patients. The analysis indicated that there was no significant difference in the risk of adenoma recurrence between folic acid supplementation and placebo [RR = 0.97,95% CI (0.79,1.19), P = 0.76], while the risk of recurrent adenoma was higher in both groups There was a statistically significant difference [RR = 1.33, 95% CI (1.01, 1.74), P = 0.04]. This effect was observed at 1 mg / 2.09), P = 0.02]. Conclusions Folic acid supplementation failed to show an effect of reducing the risk of recurrence of colorectal adenomas, which may increase the risk of recurrent adenoma.