国内儿童支气管哮喘控制不良及影响因素的Meta分析  

Meta analysis of children with poorly controlled bronchial asthma and the influencing factors

作　　者：熊浪宇 曹学华[2] 王晓霞 贾钰 向凤 胡婉琴 孙妍[2] XIONG Langyu;CAO Xuehua;WANG Xiaoxia;JIA Yu;XIANG Feng;HU Wanqin;SUN Yan(Nursing School of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]成都中医药大学护理学院,四川省成都市610075 [2]四川省人民医院,四川省成都市610072

出　　处：《护理实践与研究》2024年第11期1598-1608,共11页Nursing Practice and Research

基　　金：四川省科技厅重点研发计划(编号:23ZDYF1480)。

摘　　要：目的采用Meta分析方法探讨中国儿童支气管哮喘控制不良的状况及影响因素,为避免儿童哮喘恶化提供循证依据。方法检索中国知网、中国生物医学文献服务系统、维普网、万方数据知识服务平台、Web of Science、Pubmed、Cochrane、Embase数据库中关于中国儿童支气管哮喘控制不良情况及影响因素的病例对照研究、队列研究及横断面研究文献,检索时限从建库至2023年4月,按照纳入与排除标准由两名研究者独立筛选文献及质量评价,采用Stata17软件进行Meta分析。结果共纳入21篇文献,涉及16008例患儿,儿童支气管哮喘控制不良发生率为49%(95%CI:0.43,0.55),亚组分析显示,不同症状评估工具和地区的哮喘控制不良率差异较大,其中GINA工具70%(95%CI:0.61,0.78)和西北地区67%(95%CI:0.58,0.75)最高。反复呼吸道感染、用药依从性、哮喘家族史、过敏性鼻炎、未定期复诊、被动吸烟史以及个人过敏史是哮喘控制不良的危险因素,患儿家长学历、家庭经济水平和家长认知水平是保护因素。经过敏感性分析和Egger检验后,无明显发表偏倚。结论中国儿童哮喘控制不良发生率较高,反复呼吸道感染、用药依从性、哮喘家族史、过敏性鼻炎、未定期复诊、被动吸烟史、个人过敏史、家长学历、家庭经济水平和家长认知水平是哮喘控制不良的影响因素。Objective To investigate the status of poorly controlled bronchial asthma in Chinese children and taking the Meta analysis to find out the influencing factors,and to provide evidence-based basis for avoiding the deterioration of asthma in children.Methods We searched case-control studies,cohort studies,and cross-sectional studies on the status of poor control of bronchial asthma in Chinese children and the influencing factors in the China Knowledge Network(CNN),China Biomedical Literature Service System(CBLS),Wipro,Wanfang Data Knowledge Service Platform(WDKSP),Web of Science(Web of Science),Pubmed,Cochrane,and Embase databases.Literature was searched from the establish of database to April 2023,and two researchers independently screened and evaluated the quality of the literature according to the inclusion and exclusion criteria,and Meta analysis was performed using Stata17 software.Results The incidence of poorly controlled childhood bronchial asthma was 49%(95%CI:0.43,0.55),and subgroup analyses showed that the rate of poorly controlled asthma varied widely by symptom assessment tool and region,with the GINA tool at 70%(95%CI:0.61,0.78)and the Northwest Region at 67%(95%CI:0.58,0.58)were the highest.Recurrent respiratory infections,medication adherence,family history of asthma,allergic rhinitis,lack of regular follow-ups,history of passive smoking,and personal history of allergies were risk factors for poor asthma control,while parental education,family economic level,and parental awareness were protective factors.After sensitivity analysis and Egger's test,there was no significant publication bias.Conclusion The incidence of poor asthma control in Chinese children was high.Recurrent respiratory infections,medication adherence,family history of asthma,allergic rhinitis,lack of regular follow-ups,history of passive smoking,personal history of allergy,parental education,family economic level and parental awareness were the factors influencing poor asthma control.

关 键 词：哮喘 儿童 控制不良 影响因素 META分析 患儿家长 

分 类 号：R471[医药卫生—护理学]