田林　戴子一　黄磊　戴七一

【摘 要】目的：系统评价女性血清性激素水平与类风湿关节炎的相关性。方法：计算机检索中国知网、重庆维普、万方、PubMed、Cochrane Library等数据库，收集所有相关血清性激素水平与类风湿关节炎相关性的病例对照研究。由2名评价者运用Jadad量表对纳入研究的文献质量进行独立评价并提取资料，采用Review Manage 5.2软件进行Meta分析。通过对森林图和漏斗图的分析判断女性血清性激素水平与类风湿关节炎疾病的相关性。结果：经筛选，共纳入9项研究，累计病例510例，其中病例组286例，对照组224例。女性类风湿关节炎患者血清性激素含量与正常对照组差异有统计学意义（P < 0.05）。结论：女性类风湿关节炎疾病的发生与血清性激素水平直接相关，但具体影响机制和相关活动度尚需进一步研究证实。

【关键词】 关节炎，类风湿；血清性激素；女性；代谢组学；Meta分析

doi：10.3969/j.issn.2095-4174.2016.01.006

Meta-analysis of the Relationship Between Serum Sex Hormone Level and Rheumatoid Arthritis in Women

TIAN Lin，DAI Zi-yi，HUANG Lei，DAI Qi-yi

【ABSTRACT】Objective：To systematically evaluate the relationship between serum sex hormone level and rheumatoid arthritis in women.Methods：A retrieval was made to collect all the researches on the relationship between serum sex hormone level and rheumatoid arthritis in women from databases such as CNKI，Wanfang Data，PubMed and Cochrane Library.An independent evaluation was made by 2 reviewers using the Jadad table on the collected literature and a meta-analysis was made with Review Manager 5.2 software.A judgment was made on the correlation between serum hormone levels and rheumatoid arthritis in women by the analysis of the forest map and funnel plot.Results：After screening，9 studies were chosen，with a total of 510 cases，224 of which were in the case group and 286 in the control group.The difference of serum sex hormone between women with rheumatoid arthritis and those in the normal control group was statistically significant （P < 0.05）.Conclusion：The occurrence of rheumatoid arthritis in women is directly related with serum sex hormone levels，but the specific influence mechanism and related activity degree are required further study.

【Keywords】 arthritis，rheumatoid；serum sex hormone；female；metabolism；Meta-analysis

类风湿关节炎（rheumatoid arthritis，RA）是一种自身免疫性疾病，其病因迄今尚不明确，有研究表明，性激素及相关细胞因子水平异常在RA发病中起着重要作用[1]。女性RA发病率约为男性的2～3倍[2-3]，说明RA的发病可能与性激素有关，但相关研究对RA与各类性激素关系的活动度相关性问题上一直存在争议。本研究运用循证医学Meta分析方法，收集相关病例研究，选择人体血清含量较高的雌二醇（E2）、睾酮（Te）2种性激素为观测指标，通过对女性RA患者和健康人血清性激素水平的综合分析和系统评价，探讨血清性激素水平变化与RA的相关性，为RA的临床防治提供参考依据。

1 资料与方法

1.1 文献检索 中文以“类风湿关节炎、性激素”为关键词在中国知网、重庆维普和万方3个中文数据库，英文以Pubmed、Cochrane library 2个英文数据库检索相关文献及其引文。……