儿童抽动障碍致病危险因素的系统评价  被引量:22

Risk factors for children with tic disorder:a systematic review

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作  者:路晨 郝宏文[2] 廖欣婷 王宝盛 李盼盼 吴力群[2] LU Chen;HAO Hongwen;LIAO Xinting;WANG Baosheng;LI Panpan;WU Liqun(Beijing University of Chinese Medicine,Beijing 100029,P.R.China;Department of Pediatrics,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,P.R.China)

机构地区:[1]北京中医药大学,北京100029 [2]北京中医药大学第二附属东方医院儿科,北京100078

出  处:《中国循证医学杂志》2021年第12期1407-1415,共9页Chinese Journal of Evidence-based Medicine

基  金:中国民族医药学会科研项目(编号:2020ZY276-400501);北京中医药大学2020年度基本科研业务费项目(编号:2020-JYB-ZDGG-135)。

摘  要:目的系统评价儿童抽动障碍(tic disorder,TD)致病的危险因素。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、CNKI、CBM、VIP和WanFang Data数据库,搜集儿童抽动障碍致病危险因素的观察性研究,检索时限均从建库至2021年6月29日。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入32个研究,包括556560例儿童。TD致病危险因素为:男性[OR=2.23,95%CI(1.08,4.61),P=0.03]、早产[OR=1.66,95%CI(1.04,2.64),P=0.03]、低出生体重[OR=1.27,95%CI(1.07,1.50),P=0.005]、新生儿黄疸病史[OR=7.46,95%CI(1.15,48.42),P=0.04]、围生期其他不利因素[OR=2.74,95%CI(1.89,3.98),P<0.00001]、不良饮食习惯[OR=2.11,95%CI(1.52,2.93),P<0.00001]、长时间看电子产品[OR=2.22,95%CI(1.31,3.75),P=0.003]、高热惊厥史[OR=2.43,95%CI(1.21,4.86),P=0.01]、反复呼吸道感染[OR=2.63,95%CI(1.49,4.64),P=0.0008]、慢性扁桃体炎[OR=2.01,95%CI(1.31,3.09),P=0.001]、鼻病[OR=1.77,95%CI(1.35,2.31),P<0.0001]、注意力缺陷多动障碍[OR=5.32,95%CI(3.77,7.51),P<0.00001]、血铁含量降低[OR=3.68,95%CI(1.56,8.67),P=0.003]、抽动障碍家族史[OR=6.33,95%CI(3.20,12.53),P<0.00001]、家族精神性疾病史[OR=2.39,95%CI(2.03,2.83),P<0.00001]、母亲孕期精神障碍[OR=2.49,95%CI(1.99,3.11),P<0.00001]、孕期饮酒[OR=1.40,95%CI(1.09,1.79),P=0.007]、孕期吸烟或被动吸烟[OR=1.84,95%CI(1.68,2.01),P<0.00001]和打骂体罚的教育方式[OR=3.57,95%CI(1.52,8.34),P=0.003]。胎次(二胎及以上)[OR=0.41,95%CI(0.25,0.68),P=0.0006]是抽动障碍发生的保护因素。结论当前证据表明,TD发病与性别、家族精神性疾病史、母亲孕期生活习惯、围生期病史、慢性呼吸系统疾病、微量元素异常、严苛的教育方式等相关,胎次是TD发生的保护因素。受纳入研究数量与质量限制,上述结论尚需更多高质量研究予以验证。Objective To systematically review the risk factors of tic disorder(TD)in children.Methods Databases including PubMed,EMbase,The Cochrane Library,Web of Science,CNKI,CBM,VIP,and WanFang Data were electronically searched to collect observational studies on children with TD from inception to June 29 th 2021.Two reviewers independently screened literature,extracted data,and assessed the risk of bias of the included studies.Metaanalysis was then performed using RevMan 5.3 software.Results A total of 32 studies involving 556560 children were included.The results of meta-analysis showed that the risk factors for TD were as follows:male(OR=2.23,95%CI 1.08 to4.61,P=0.03),premature delivery(OR=1.66,95%CI 1.04 to 2.64,P=0.03),low birth weight(OR=1.27,95%CI 1.07 to 1.50,P=0.005),history of neonatal jaundice(OR=7.46,95%CI 1.15 to 48.42,P=0.04),other adverse factors in the perinatal period(OR=2.74,95%CI 1.89 to 3.98,P<0.00001),poor eating habits(OR=2.11,95%CI 1.52 to 2.93,P<0.00001),longterm viewing of electronic products(OR=2.22,95%CI 1.31 to 3.75,P=0.003),history of febrile convulsions(OR=2.43,95%CI 1.21 to 4.86,P=0.01),recurrent respiratory infection(OR=2.63,95%CI 1.49 to 4.64,P=0.0008),chronic tonsillitis(OR=2.01,95%CI 1.31 to 3.09,P=0.001),rhinopathy(OR=1.77,95%CI 1.35 to 2.31,P<0.0001),attention deficit hyperactivity disorder(ADHD)(OR=5.32,95%CI 3.77 to 7.51,P<0.00001),decreased blood iron content(OR=3.68,95%CI 1.56 to 8.67,P=0.003),family history of TD(OR=6.33,95%CI 3.20 to 12.53,P<0.00001),family history of mental illness(OR=2.39,95%CI 2.03 to 2.83,P<0.00001),maternal mental disorder during pregnancy(OR=2.49,95%CI 1.99 to3.11,P<0.00001),alcohol drinking during pregnancy(OR=1.40,95%CI 1.09 to1.79,P=0.007),smoking or passive smoking during pregnancy(OR=1.84,95%CI 1.68 to 2.01,P<0.00001),and corporal punishment(OR=3.57,95%CI 1.52 to 8.34,P=0.003).Parity(second birth and above)(OR=0.41,95%CI 0.25 to 0.68,P=0.0006)was a protective factor for tic disorder.Conclusions Current evidence shows that the incidence of TD is relate

关 键 词:抽动障碍 危险因素 儿科 系统评价 META分析 

分 类 号:R749.94[医药卫生—神经病学与精神病学]

 

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