有机磷农药与再生障碍性贫血发病关系的Meta分析

目的 评价有机磷农药与再生障碍性贫血发病的关系,为一级预防提供科学依据。方法 检索1990年1月至2014年8月公开发表在中国生物医学文献数据库(CBM)、中国知网(CNKI)、PubMed和EMBASE关于有机磷农药与再生障碍性贫血发病关系的病例对照研究。制定纳入和排除标准,对符合纳入标准的文献进行质量评价,利用Review Manager 5.0软件计算有机磷农药的合并OR值及其95%CI,并对文献的研究人群和有机磷农药使用方式进行亚组分析。结果 最终共纳入9篇文献,5 833例研究对象,其中病例组1 404人,对照组4 429人。结果显示有机磷农药可增加再生障碍性贫血的发病风险(OR=1.97,95%CI:1.60～2.44)。亚组分析显示亚洲人群再生障碍性贫血的发病风险(OR=2.01,95%CI:1.52～2.66)高于欧美人群(OR=1.93,95%CI:1.39～2.67);使用单一有机磷类农药(OR=2.15,95%CI:1.60～2.88)比使用有机磷类农药的混配制剂(OR=1.82,95%CI:1.34～2.47)更易引发再生障碍性贫血。结论 有机磷农药可能是再生障碍性贫血的危险因素。在日常生活和工农业生产中,减少有机磷农药的暴露,可以预防再生障碍性贫血的发生。

Meta-analysis of association between organophosphorus pesticides and aplastic anemia

Objective To evaluate the association between organophosphorus pesticides and aplastic anemia,and provide scientific evidence for the primary prevention of aplastic anemia. Methods The published papers of case control studies on the association between organophosphorus pesticides and aplastic anemia from January 1990 to August 2014 were collected from Chinese BioMedical Literature Base(CBM),Chinese National Knowledge Infrastructure (CNKI),PubMed and EMBASE. The papers which met the inclusion criteria were evaluated. The pooled odds ratios (OR) and 95% confidence interval(CI) of organophosphorus pesticides were calculated with software Review Manager 5.0. Subgroup analysis were conducted for different population and different usage of organophosphorus pesticides. Results A total of 9 papers were selected,involving 5 833 subjects (1 404 cases and 4 429 controls). The results showed that organophosphorus pesticides could increase the risk of aplastic anemia (OR=1.97,95%CI:1.60-2.44). Subgroup analysis showed that Asian(OR=2.01,95%CI:1.52-2.66) had higher risk of aplastic anemia than American or European(OR=1.93,95%CI:1.39-2.67). Using pure organophosphorus pesticides (OR=2.15,95%CI:1.60-2.88) was more prone to cause aplastic anemia than using the mixture of organophosphorus pesticides (OR=1.82,95%CI:1.34-2.47). Conclusion The analysis indicated that organophosphorus pesticides might be a risk factor for aplastic anemia. Reducing organophosphorus pesticides exposure in daily life and industrial or agricultural production could prevent the incidence of aplastic anemia.