Wang Xi, Ning Yujie, Liu Amin, Qi Xin, Liu Meidan, Zhang Pan, Guo Xiong
School of Public Health, Xi'an Jiaotong University Health Science Center, Key Laboratory of Trace Elements and Endemic Diseases, National Health and Family Planning Commission, No.76 Yanta West Road, 710061, Xi'an, People's Republic of China.
Xi'an Jiaotong University Global Health Institutes, No.76 Yanta West Road, Xi'an, 710061, People's Republic of China.
BMC Musculoskelet Disord. 2019 Feb 14;20(1):78. doi: 10.1186/s12891-019-2461-z.
Kashin-Beck disease (KBD) is a serious human endemic chronic osteochondral disease. However, quantitative syntheses of X-ray detective rate studies for KBD are rare. We performed an initial systematic review and meta-analysis to assess the X-ray detective rate of KBD in China.
For this systematic review and meta-analysis, we searched five databases (PubMed, Web of Science, Chinese National Knowledge Infrastructure (CNKI), WanFang Data and the China Science and Technology Journal Database (VIP))using a comprehensive search strategy to identify studies of KBD X-ray detective rate in China that were published from database inception to January 13, 2018. The X-ray detective rate of KBD was determined via an analysis of published studies using a random effect meta-analysis with the proportions approach. Subgroup analysis and meta-regression were used to explore heterogeneity, and study quality was assessed using the risk of bias tool.
A total of 53 studies involving 14,039 samples with X-ray detective rate in 163,340 observations in total were included in this meta-analysis. These studies were geographically diverse (3 endemic areas). The pooled overall X-ray detective rate for KBD was 11% (95%CI,8-15%;Z = 13.14; p < 0.001). The pooled X-ray detective rate estimates were 11% (95%CI, 6-17%; Z = 7.06; p < 0.001) for northeast endemic areas, 13% (95%CI, 7-20%; Z = 7.45; p < 0.001) for northwest endemic areas, and 8% (95%CI, 5-12%; Z = 7.90; p < 0.001) for southwest endemic areas. There was a significant relationship between the survey year and the X-ray detective rate of KBD.
Our systematic review found that the summary estimate of the X-ray detective rate of KBD was 11% and, that KBD X-ray positive rate ranged from 8.00 to 15.00% depending on the study. Further research is required to identify effective strategies for preventing and treating KBD.
大骨节病（KBD）是一种严重的人类地方性慢性骨软骨病。然而，针对大骨节病X线检出率研究的定量综合分析较为少见。我们开展了一项初步的系统评价和荟萃分析，以评估中国大骨节病的X线检出率。
对于这项系统评价和荟萃分析，我们采用全面检索策略，检索了五个数据库（PubMed、Web of Science、中国知网（CNKI）、万方数据和维普资讯网（VIP）），以识别从数据库建库至2018年1月13日发表的有关中国大骨节病X线检出率的研究。通过使用随机效应荟萃分析的比例法对已发表研究进行分析，确定大骨节病的X线检出率。采用亚组分析和荟萃回归探讨异质性，并使用偏倚风险工具评估研究质量。
本荟萃分析共纳入53项研究，涉及14,039个样本，总计163,340次观察中的X线检出率。这些研究在地理上具有多样性（3个病区）。大骨节病的合并总体X线检出率为11%（95%CI，8-15%；Z = 13.14；p < 0.001）。东北病区的合并X线检出率估计为11%（95%CI，6-17%；Z = 7.06；p < 0.001），西北病区为13%（95%CI，7-20%；Z = 7.45；p < 0.001），西南病区为8%（95%CI，5-12%；Z = 7.90；p < 0.001）。调查年份与大骨节病的X线检出率之间存在显著关系。
我们的系统评价发现，大骨节病X线检出率的汇总估计值为11%，且根据研究不同，大骨节病X线阳性率在8.00%至15.00%之间。需要进一步研究以确定预防和治疗大骨节病的有效策略。
