育龄妇女人群实施神经管缺陷综合干预措施的效果分析

目的了解国内在育龄妇女人群中实施神经管缺陷(NTDs)综合干预措施的预防效果。方法全面搜集国内发表的关于在育龄妇女人群中实施NTDs综合干预措施文献,共有12篇文献符合纳入标准(累计381?561人接受综合干预措施)。将纳入文献按南北地域归类,分别汇总文献的总体效应值。采用Woolf法对文献研究结果进行齐性检验,根据结果选取汇总纳入文献研究结果总体效应值的分析方法,研究结果趋于一致时,采用Peto法;研究结果间差异较大时,采用D L法。结果① 12篇文献的研究结果差异较大(Q=20443?6, P＜005),综合干预措施效应强度RR为0556?5(95％CI:0544?6～0568?7),保护率(PR)为4435％;② 南方地域的2篇文献研究结果趋于一致(Q=0068?4,P＞005),综合干预措施效应强度RR为0673?5(95％CI:0576?7～0786?5),PR为3265％。北方地域的10篇文献研究结果趋于一致(Q=16553?8,P＞005),综合干预措施效应强度RR为0513?1(95％CI:0428?3～0614?6),PR为4869％;结论目前国内在育龄妇女人群中综合干预措施可降低NTDs的发病风险,但预防率仍然较低。北方地域综合干预措施预防率高于南方地域。在育龄妇女中开展的NTDs综合干预措施尚需进一步完善。

Effects of integrated intervention measurements on neural tube defects in Chinese women of childbearing age

To estimate the effects of integrated measures on reducing the risks of neural tube defects in Chinese women of childbearing age. MethodsOn the basis of all the relative studies collected, twelve studies with a total of 381561 subjects accepted the interventions。 Intervention areas were divided into two parts: the northern areas and the southern areas. The combined values were evaluated. First, the Woolf method was used for the homogeneity test. If analysis results are homogenous, the Peto method was used to evaluate the combined value, otherwise the D L method was used. Results① Results of the twelve studies were heterogeneous (Q=20443?6, P＜005) and the D L method was applied to evaluate the combined value. RR(relative risk) was 05565 and its 95％CI(95％ Confidence Interval) was 0544?6 to 0568?7, and PR(protective rate) was 4435％. ② Results of the two studies in the southern areas were homogenous (Q=0068?4,P＞005). RR(95％CI)was 0673?5(0576?7 to 0786?5) and PRwas 3265％. Results of the ten studies in the northern areas were homogenous (Q=16553?8, P＞005). RR(95％CI)was 0513?1(0428?3 to 0614?6)and PR　was 4869％. ConclusionRisks of NTDs were reduced after putting integrated intervention measurements on women of childbearing age, but the whole protective rate did not reach the expectation. The protective rate in the northern areas was better than that in the southern areas. Integrated intervention measurements should be improved in order to make them work more effectively.