中国血流感染住院病死率的系统评价和meta分析  

Fatality and secular trend of bloodstream infections during hospitalization in China:A systematic review and meta-analysis

作　　者：杨祖耀[1] 詹思延[1] 王波[1] 吕晓珍[1] 舒正[1] 何英剑[1] 邱宁 杨慧英 

机构地区：[1]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [2]阿斯利康制药有限公司(中国) [3]阿斯利康制药有限公司(美国)

出　　处：《北京大学学报（医学版）》2010年第3期304-307,共4页Journal of Peking University:Health Sciences

摘　　要：目的：了解我国血流感染（bloodstream infection,BSI）住院期间的病死率及其长期趋势。方法：系统检索《中国生物医学文献数据库》（CBM）、《中国期刊全文数据库》（CNKI）及《中文科技期刊数据库》（VIP）收录的＂核心期刊＂中1990年至2008年8月发表的文献,选择报告了BSI住院病死率的无对照观察性研究,摘录有关信息,用广义倒方差模型进行meta分析。结果：共纳入72篇文献,加权合并的BSI病死率为28.7%（95%CI：27.2%~30.3%）,各个研究之间存在较大的异质性。普通住院患者BSI的病死率为20.7%（95%CI：17.8%~24.0%）,烧伤、血液病和/或恶性肿瘤以及重症监护室的患者BSI病死率更高,而在新生儿病房、肝病及糖尿病患者中则相对较低。医院BSI病死率为26.8%（95%CI：22.4%~32.0%）,明显高于社区BSI的病死率。近几十年来,BSI住院病死率呈下降趋势。结论：我国BSI住院病死率较高,但从长期来看呈下降趋势。Objective：To get an overview of the fatality and secular trend of bloodstream infection（BSI）during hospitalization in China.Methods：Papers published between 1990 and Aug.2008 on the core journals included by Chinese Biomedical Literature Database（CBM）,China National Knowledge Infrastructure（CNKI）and VIP Chinese Periodical Database were systematically searched.Studies providing data of BSI fatality during hospitalization with a non-comparative,observational design were included.Meta-analysis was done using the generic inverse variance model.Results：Overall,72 studies were included for this analysis.The weighted BSI fatality in-hospital based on them was 28.7%（95%CI：27.2%-30.3%）,with substantial differences between study and heterogeneity.For BSI cases from across all departments of hospitals,the weighed fatality was 20.7%（95%CI：17.8%-24.0%）.In the departments of burn,hematology and/or malignant tumors,and ICU,BSI fatalities were even higher,but were relatively low among BSI cases from neonatal wards,and patients with liver diseases,or diabetes mellitus.Fatality of hospital acquired BSI（HA-BSIs,26.8%,95%CI：22.4%-32.0%）was significantly higher than that of community acquired BSI（CA-BSIs）.For the past decades,BSI fatality has declined in various kinds of inpatients.Conclusion：BSI fatality during hospitalization was at a high level in China,but with a downward trend over the past decades.

关 键 词：毒血症 败血病 死亡率 系统综述 META分析 

分 类 号：R515.3[医药卫生—内科学]