目的 系统评价毛细支气管炎患儿在出院后复发喘息的危险因素,为减少喘息的发生提供依据。方法 计算机检索建库至2021年11月中国知网、维普引文数据库、 中国生物医学文献数据库、万方数据库,PubMed、the Cochrane Library 、Web of Science、EMbase等数据库中与毛细支气管炎后发生喘息的危险因素相关的研究文献,中文检索词为“毛细支气管炎、喘息、危险因素”,英文检索词为“bronchiolitis、bronchiolitides、 respiratory sound 、wheezing 、stridor、risk factors”。2名研究员独立对文献进行阅读筛选,进行质量评价,提取资料,采用RevMan5.3软件进行Meta分析。结果 共纳入13篇文献,其中中文6篇,英文7篇。分析结果显示男童(OR=1.26, 95%CI:1.04~1.54),湿疹史(OR=2.68,95%CI:2.02～3.56), 个人过敏史(OR=4.42,95%CI:3.31～5.91),家族哮喘史(OR=3.72,95%CI: 2.38～5.83),家族特应性病史(OR=2.75,95%CI:1.50～5.04)、烟草暴露(OR=2.68,95%CI:1.44～4.99)是毛细支气管炎后复发喘息的危险因素,母乳喂养(OR=0.47,95%CI:0.23～0.96)为保护因素。结论 引起婴幼儿毛细支气管炎后复发喘息的危险因素较多,首要危险因素是个人过敏史,其次为家族哮喘史、家族特应性病史、湿疹史、烟草暴露、男童,母乳喂养是一个保护因素。
Abstract
Objective To systematically analyze the risk factors of recurring wheezing after bronchiolitis, in order to provide reference for reducing wheezing. Methods CNKI, Wanfang Data, Chinese biomedical literature database, VIP, Web of science, PubMed, Cochrane and Embase were searched until November 2021. The Chinese search term included bronchiolitis, wheezing and risk factors, the English search terms were bronchiolitis, bronchiolitides, respiratory sound, wheezing, stridor and risk factors. Two researchers both read and evaluated the documents individually. Data was extracted by researchers using RevMan 5.3 software. Meta-analysis was then performed with RevMan5.3 software. Results Totally 13 studies were finally included, of which six studies were in Chinese and seven studies in English. Meta-analysis results showed that the main risk factors for recurrent wheezing after bronchiolitis included boys (OR=1.26,95%CI:1.04 - 1.54), a history of eczema (OR=2.68, 95%CI:2.02 - 3.56), personal history of allergy (OR=4.42, 95%CI:3.31 - 5.91), family history of asthma (OR=3.72, 95%CI: 2.38 - 5.83), family history of atopic disease (OR=2.75, 95%CI: 1.50 - 5.04) and tobacco exposure (OR=2.68, 95%CI:1.44-4.99),while breastfeeding was a protective factor (OR=0.47, 95%CI:0.23 - 0.96). Conclusions There are lots of risk factors for recurrent wheezing after bronchiolitis in children, among which the leading risk factor is personal history of allergy, followed by family history of asthma, family history of atopic disease, history of eczema, tobacco exposure, boys, while breastfeeding may reduce the prevalence of recurrent wheezing after bronchiolitis.
关键词
毛细支气管炎 /
喘息 /
Meta分析 /
危险因素
Key words
bronchiolitis /
wheezing /
Meta-analysis /
risk factors
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基金
天津市自然基金重大项目(20JCZDJC00630)
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