儿童腺病毒肺炎后并发闭塞性细支气管炎危险因素Meta分析  

Meta-analysis of risk factors for obliterative bronchiolitis after adenovirus pneumonia in children

作　　者：吴记梅 吴记红 杨图宏[1] 钟礼立[1] Wu Jimei;Wu Jihong;Yang Tuhong;Zhong Lili(Department of pediatrics/Hunan Provincial Key Laboratory of Children's Respiratory Diseases,Hunan provincial people's hospital(the first affiliated hospital of Hunan Normal University),Changsha,Hunan,410005,China;Department of respiratory medicine,Zhuzhou central hospital,Zhuzhou,Hunan,412000,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)儿科/儿童呼吸病学湖南省重点实验室,湖南长沙410005 [2]株洲市中心医院呼吸科,湖南株洲412000

出　　处：《齐齐哈尔医学院学报》2023年第12期1155-1160,共6页Journal of Qiqihar Medical University

基　　金：湖南省卫生健康委员会一般资助课题(B202314046127)。

摘　　要：目的系统评价儿童腺病毒肺炎后发生闭塞性细支气管炎的危险因素。方法计算机检索PubMed、Embase、Web of Science、中国知网、维普数据库、万方医学数据库和中国生物医学文献数据库,搜集有关儿童腺病毒肺炎后发生闭塞性细支气管炎危险因素的病例对照研究和队列研究,检索时限均为建库至2022年7月。由2名研究员独立完成文献筛选、数据提取和质量评价后,使用RevMan5.4软件进行Meta分析。结果共纳入11个研究,共1672名患儿,病例组350例,对照组1322例。Meta分析结果显示:年龄[WMD=-4.22,95%CI[-5.86,-2.59],P<0.0001]、住院天数[WMD=4.39,95%CI(1.73,7.04),P<0.001]、热程[WMD=2.60,95%CI(0.96,4.23),P<0.01]、呼吸机使用时间[WMD=3.55,95%CI(0.53,6.56),P=0.02]、机械通气[OR=11.85,95%CI(6.70,20.96),P<0.0001]、喘息[OR=2.40,95%CI(2.01,2.88),P<0.0001]、呼吸困难[OR=11.70,95%CI(6.93,19.77),P<0.0001]、合并细菌感染[OR=2.02,95%CI(1.32,3.10),P<0.01]均是儿童腺病毒肺炎后发生闭塞性细支气管炎的危险因素。结论当前证据表明,年龄小、住院天数、热程及呼吸机使用时间长、急性期喘息与呼吸困难症状、合并细菌感染及使用机械通气辅助治疗是儿童腺病毒肺炎后发生感染后闭塞性细支气管炎的危险因素。Objective To systematically review the risk factors for bronchiolitis obliterans after adenovirus pneumonia in children.Methods Case-control studies and cohorts research on risk factors for bronchiolitis obliterans after adenovirus pneumonia in children were screened from the databases of PubMed,Embase,Web of Science,CNKI,VIP database,Wanfang Medical Database,and Chinese Biomedical Literature Database by using computer,the retrieval time limit is from the establishment of the database until July 2022.The literature screening,data extraction and quality evaluation were independently completed by 2 researchers,then Meta-analysis was performed using RevMan5.4 software.Results A total of 11 studies were enrolled in the research,a total of 1672 children were included,including 350 cases in the case group and 1322 in the control group.Meta-analysis results showed:age[WMD=-4.22,95%CI[-5.86,-2.59],P<0.0001],length of hospital stay[WMD=4.39,95%CI(1.73,7.04),P<0.001],fever duration[WMD=2.60,95%CI(0.96,4.23),P<0.01],ventilator use time[WMD=3.55,95%CI(0.53,6.56),P=0.02],mechanical ventilation[OR=11.85,95%CI(6.70,20.96),P<0.0001],wheezing[OR=2.40,95%CI(2.01,2.88),P<0.0001],dyspnea[OR=11.70,95%CI(6.93,19.77),P<0.0001],and bacterial infection[OR=2.02,95%CI(1.32,3.10),P<0.01]were the risk factors for bronchiolitis obliterans after adenovirus pneumonia in children.Conclusions Current evidence suggests that younger age,length of hospital stay,prolonged heat and ventilator use,acute-phase wheezing and dyspnea symptoms,comorbid bacterial infections,and use of mechanical ventilation are associated with post-infectious bronchiolitis obliterans in children with adenovirus pneumonia.

关 键 词：腺病毒 肺炎 闭塞性细支气管炎 危险因素 META分析 

分 类 号：R725.6[医药卫生—儿科]