目的 系统评价中国儿童哮喘急性发作的主要危险因素,为儿童哮喘急性发作的早期防治和改善预后提供参考依据。方法 利用计算机系统收集中国知网、万方、维普、Web of Science、PubMed、Cochrane和Embase等数据库从建库至2020年5月31日关于中国儿童哮喘急性发作危险因素的研究。由双人独立对资料进行初步筛选和信息提取以进行质量控制,使用Cochrane官方提供的RevMan 5.3软件进行Meta分析。结果 共纳入8篇病例对照研究定性分析,其中7篇进行定量分析评价,病例组1 170例,对照组882例。经Meta分析发现,儿童哮喘急性发作的主要危险因素包括呼吸道感染史(OR=1.68,95%CI:1.20～2.35)、被动吸烟史(OR=1.99,95%CI:1.47～2.69)、哮喘家族史(OR=2.11,95%CI:1.57～2.84)、患儿过敏史(OR=3.84,95%CI:2.27～6.48)和未规范用药(OR=2.83,95%CI:1.69～4.75),而母乳喂养则是其保护因素(OR=0.48,95%CI:0.31～0.72)。结论 引起中国儿童哮喘急性发作的危险因素较多,其中患儿过敏史是首要危险因素,其次是未规范用药和哮喘家族史,而母乳喂养则能够降低儿童哮喘急性发作的风险。
Abstract
Objective To systematically evaluate the main risk factors for acute attack of asthma in Chinese children,and to provide basis for early prevention,treatment and improvement of prognosis of acute attack of asthma in children. Methods Databases of CNKI,Wanfang Data,VIP,Web of science,PubMed,Cochrane and Embase were searched to systematically collect literatures from the establishment to May 31st,2020 to study the risk factors of Chinese children's acute asthma attack.The data were screened and extracted by two persons independently for quality control,and the RevMan5.3 software provided by Cochrane was used for Meta-analysis. Results A total of 8 case-control studies were included in the qualitative analysis,of which 7 were evaluated quantitatively,including 1 170 cases in the case group and 882 cases in the control group.Meta-analysis showed that the main risk factors for acute attack of asthma in children included history of respiratory tract infection(OR=1.68,95%CI:1.20—2.35),history of passive smoking(OR=1.99,95%CI:1.47—2.69),family history of asthma(OR=2.11,95%CI:1.57—2.84),history of allergy in children(OR=3.84,95%CI:2.27—6.48)and unstandardized medication(OR=2.83,95%CI:1.69—4.75),while breastfeeding was a protective factor(OR=0.48,95%CI:0.31—0.72). Conclusions There are many risk factors for acute attack of asthma in Chinese children,among which the history of allergy is the primary risk factor,followed by unstandardized medication and family history of asthma,while breastfeeding can reduce the risk of acute attack of asthma in children.
关键词
儿童 /
哮喘急性发作 /
危险因素 /
Meta分析 /
母乳喂养 /
过敏
Key words
children /
acute attack of asthma /
risk factors /
Meta-analysis /
breastfeeding /
allergy
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