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口服避孕药或激素替代疗法是否能预防女性颅内动脉瘤的形成或破裂？系统评价和荟萃分析。

Does the use of oral contraceptives or hormone replacement therapy offer protection against the formation or rupture of intracranial aneurysms in women?: a systematic review and meta-analysis.

机构信息

Hospital Sírio Libanês - São Paulo (SP), Brazil.

Sociedade de Neurocirurgia do Rio de Janeiro - Rio de Janeiro (RJ), Brazil.

出版信息

Rev Assoc Med Bras (1992). 2023 Aug 4;69(suppl 1):e2023S118. doi: 10.1590/1806-9282.2023S118. eCollection 2023.

DOI:10.1590/1806-9282.2023S118
PMID:37556637
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10411690/
Abstract

OBJECTIVE

The aim of this study was to carry out a systematic review of the literature with meta-analysis to evaluate the effect of using oral contraceptive and hormone replacement therapy as a protective factor in the formation of intracranial aneurysms and subarachnoid hemorrhage.

METHODS

This is a systematic review of the literature with meta-analysis, using PubMed and Embase as databases and the PRISMA method. Case-control and cohort studies published until December 2022 were included in this review.

RESULTS

Four studies were included in this review; three of which were eligible for meta-analysis. Regarding the use of oral contraceptive and the development of subarachnoid hemorrhage, there was a lower risk of aneurysm rupture with an odds ratio 0.65 (confidence interval 0.5-0.85). In the analysis of patients using hormone replacement therapy and developing subarachnoid hemorrhage, there was also a lower risk of aneurysm rupture with an OR 0.54 (CI 0.39-0.74). Only one article analyzed the formation of intracranial aneurysm and the use of hormone replacement therapy and oral contraceptive, and there was a protective effect with the use of these medications. oral contraceptive: OR 2.1 (CI 1.2-3.8) and hormone replacement therapy: OR 3.1 (CI 1.5-6.2).

CONCLUSION

The use of hormone replacement therapy and oral contraceptive has a protective effect in intracranial aneurysm rupture and formation.

摘要

目的

本研究旨在进行系统评价和荟萃分析，评估口服避孕药和激素替代疗法作为颅内动脉瘤和蛛网膜下腔出血形成的保护因素的效果。

方法

这是一项系统评价和荟萃分析，使用 PubMed 和 Embase 作为数据库，并采用 PRISMA 方法。本综述纳入了截至 2022 年 12 月发表的病例对照和队列研究。

结果

本综述纳入了 4 项研究，其中 3 项符合荟萃分析条件。关于口服避孕药与蛛网膜下腔出血发生的相关性，使用口服避孕药与蛛网膜下腔出血破裂风险降低相关，比值比（OR）为 0.65（95%置信区间 0.5-0.85）。在分析接受激素替代疗法与蛛网膜下腔出血发生的相关性的患者中，OR 为 0.54（95%置信区间 0.39-0.74）。只有一篇文章分析了颅内动脉瘤形成与激素替代疗法和口服避孕药的使用，结果显示这些药物的使用具有保护作用。口服避孕药：OR 2.1（95%置信区间 1.2-3.8），激素替代疗法：OR 3.1（95%置信区间 1.5-6.2）。

结论

激素替代疗法和口服避孕药的使用对颅内动脉瘤破裂和形成具有保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d28c/10411690/e91538fee1a1/1806-9282-ramb-69-suppl1-e2023S118-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d28c/10411690/346e8c1261cc/1806-9282-ramb-69-suppl1-e2023S118-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d28c/10411690/c13d8e990f88/1806-9282-ramb-69-suppl1-e2023S118-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d28c/10411690/e91538fee1a1/1806-9282-ramb-69-suppl1-e2023S118-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d28c/10411690/346e8c1261cc/1806-9282-ramb-69-suppl1-e2023S118-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d28c/10411690/c13d8e990f88/1806-9282-ramb-69-suppl1-e2023S118-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d28c/10411690/e91538fee1a1/1806-9282-ramb-69-suppl1-e2023S118-gf03.jpg

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本文引用的文献

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The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.PRISMA 2020 声明：系统评价报告的更新指南。
BMJ. 2021 Mar 29;372:n71. doi: 10.1136/bmj.n71.
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Growth and rupture of unruptured intracranial aneurysms.颅内未破裂动脉瘤的生长与破裂。
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Neurology. 2012 Sep 18;79(12):1230-6. doi: 10.1212/WNL.0b013e31826aace6. Epub 2012 Sep 5.
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