中国健康人群手足口病病原体隐性感染率的Meta分析  

Prevalence of latent infection of pathogens of hand,foot and mouth disease in healthy people in China:A meta-analysis

作　　者：李鹏[1] 唐安[1] 李科峰[1] 吴昺 严剑波[1] LI Peng;TANG An;LI Kefeng;WU Bing;YAN Jianho(Zhoushan Center for Disease Control and Prevention,Zhoushan,Zhejiang 316021,China)

机构地区：[1]舟山市疾病预防控制中心,浙江舟山316021

出　　处：《预防医学》2020年第7期659-665,共7页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：舟山市科技计划项目(2017C31125)。

摘　　要：目的分析中国健康人群手足口病病原体隐性感染率及其影响因素,为预防和控制手足口病提供依据。方法系统检索中国知网、万方中国学术期刊数据库、中国生物医学文献数据库、PubMed、Web of Science、Science Direct等中英文数据库,收集2000年1月1日—2019年12月31日有关中国健康人群手足口病病原体隐性感染率的文献。采用率及其95%CI评估中国健康人群手足口病病原体隐性感染率。结果初期检索文献442篇,最终纳入文献31篇。中国健康人群人类肠道病毒(HEVs)隐性感染率为18.8%(95%CI:16.1%~21.6%),其中EV71隐性感染率为3.7%(95%CI:2.5%~4.9%),CV-A16隐性感染率为1.9%(95%CI:1.0%~2.9%),其他HEVs隐性感染率为15.1%(95%CI:11.9%~18.3%)。男性和女性HEVs隐性感染率分别为16.7%(95%CI:12.9%~20.4%)和14.4%(95%CI:10.8%~18.0%)。0~5岁和>5岁人群HEVs隐性感染率分别为24.4%(95%CI:20.4%~28.5%)和9.4%(95%CI:6.5%~12.2%)。Meta回归分析结果显示,采样时期、采样地区和研究人群是中国健康人群HEVs隐性感染率的影响因素。敏感性分析结果显示,单篇研究逐一排除前后,Meta回归分析结果差异无统计学意义(P>0.05)。Begg’s检验、Egger’s检验和漏斗图均显示存在发表偏倚。剪补法结果显示,剪补后隐性感染率较剪补前减小(P<0.05)。结论中国健康人群手足口病病原体隐性感染率较高,以其他HEVs为主。男性、0~5岁人群为HEVs隐性感染危险人群。Objective To analyze the prevalence of latent infection of pathogens of hand,foot and mouth disease(HFMD)in Chinese healthy population and its influencing factors,so as to provide reference for the prevention and control of HFMD.Methods Literature on the latent infection of HFMD was searched in Chinese and English databases,such as CNKI,Wanfang,CBMd,PubMed,Web of Science and Science Direct,from January 1,2000 to December 31,2019.The pooled rate and its 95% confidence interval(95%CI)were used to assess the latent infection rate of HFMD pathogens in healthy Chinese population.Results A total of 442 articles were retrieved,and 31 articles were finally included in the quantitative meta-analysis.The results showed that the latent infection rate of human enteroviruses in healthy Chinese population was 18.8%(95%CI:16.1%-21.6%),and the latent infection rates of EV71,CV-A16 and other HEVs were 3.7%(95%CI:2.5%-4.9%),1.9%(95%CI:1.0%-2.9%)and 15.1%(95%CI:11.9%-18.3%),respectively.The latent infection rates of HEVs in healthy men and women in China were 16.7%(95%CI:12.9%-20.4%)and 14.4%(95%CI:10.8%-18.0%),respectively.The latent infection rates of human enterovirues HEVs in the healthy population aged 0-5 years and over 5 years were 24.4%(95%CI:20.4%-28.5%)and 9.4%(95%CI:6.5%-12.2%),respectively.Meta regression analysis showed that the associated factors for the latent infection rate of HEVs in Chinese healthy population included sampling period,sampling area and study population.Sensitivity analysis showed that there was no significant change on meta results after the exclusion of individual studies one by one(P>0.05).Begg’s tests,Egger’s tests and funnel plots all indicated the existence of publication bias.Trim and fill method showed that the recessive infection rate was reduced after adjustment(P<0.05).Conclusions The latent infection rate of HFMD pathogens is high in healthy people in China,and it is mainly caused by other HEVs.Males and children aged under 5 years are at high risk of latent infection of HEVs.

关 键 词：手足口病 人类肠道病毒 隐性感染 META分析 

分 类 号：R725.1[医药卫生—儿科]