中国急危重症患者抗菌药物相关性腹泻发生率的Meta分析  

The incidence of antibiotic-associated diarrhea in critically ill patients in China:a Meta-analysis

作　　者：樊冰心 黄丽 吴浩 李佳玲 肖蓉 王智 王宇迪 刘素蓉[2] FAN Bingxin;HUANG Li;WU Hao;LI Jialing;XIAO Rong;WANG Zhi;WANG Yudi;LIU Surong(College of Nursing,Chengdu University of Traditional Chinese Medicine,Chengdu 610000,China;Department of Nursing,Chengdu First People's Hospital,Chengdu 610000,China;College of Ophthalmology,Chengdu University of Traditional Chinese Medicine,Chengdu 610000,China;College of Medicine and Life Sciences,Chengdu University of Traditional Chinese Medicine,Chengdu 610000,China;Tianfu College,Southwestern University of Finance and Economics,Deyang 618000,Sichuan Province,China)

机构地区：[1]成都中医药大学护理学院,成都610000 [2]成都市第一人民医院护理部,成都610000 [3]成都中医药大学眼科学院,成都610000 [4]成都中医药大学医学与生命科学学院,成都610000 [5]西南财经大学天府学院,四川德阳618000

出　　处：《药物流行病学杂志》2025年第3期293-305,共13页Chinese Journal of Pharmacoepidemiology

摘　　要：目的系统评价国内急危重症患者抗菌药物相关性腹泻(AAD)发生情况,为合理使用抗菌药物提供循证依据。方法计算机检索PubMed、Embase、Web of Science、Cochrane Library、CNKI、WanFang Data、VIP和SinoMed数据库,搜集关于中国急危重症患者AAD发生率的研究,检索时限均从建库至2024年4月23日。由2位研究者独立筛选文献、提取数据并评价纳入研究的偏倚风险后,采用Stata 17.0软件进行Meta分析。结果共纳入50项研究,包括26512例研究对象。Meta分析结果显示,中国急危重症患者AAD发生率为26.5%[95%CI(22.9%,30.1%)]。亚组分析结果显示,中国急危重症儿童AAD发生率为40.6%[95%CI(30.7%,50.4%)],中国急危重症成人AAD发生率为18.7%[95%CI(16.1%,21.4%)],其中华东儿童、西南成人AAD发生率最低,东北儿童、华北成人AAD发生率最高。结论我国急危重症患者AAD发生率较高,需要开展有效的干预举措,如合理遴选与规范化使用抗菌药物、早期预防和发现AAD的发生等,以降低急危重症患者因AAD导致的医疗负担,提升预后质量。Objective To systematically review the incidence of antibiotic-associated diarrhea(AAD)in critically ill patients in China,and to provide evidence-based basis for the rational use of antibiotics.Methods PubMed,Embase,Web of Science,Cochrane Library,CNKI,WanFang Data,VIP and SionMed databases were electronically searched to collect studies on the incidence of AAD in acute and critically ill patients in China from inception to April 23,2024.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was then performed using Stata 17.0 software.Results A total of 50 studies involving 26,512 subjects were included.Meta-analysis results showed that the incidence of AAD in critically ill patients in China was 26.5%[95%CI(22.9%,30.1%)].Subgroup analysis showed that the incidence of AAD in critically ill children in China was 40.6%[95%CI(30.7%,50.4%)],and in critically ill adults in China was 18.7%[95%CI(16.1%,21.4%)],among which the incidence of AAD in children in East China and adults in Southwest China was the lowest.The incidence of AAD in children and adults in Northeast China was the highest.Conclusion The incidence of AAD in critically ill patients in China is relatively high,and it is necessary to carry out effective intervention measures,such as rational selection and standardized use of antibiotics,early prevention and detection of AAD occurrence,to reduce the medical burden caused by AAD in critically ill patients and improve the quality of prognosis.

关 键 词：抗菌药物相关性腹泻 急危重症患者 发生率 META分析 

分 类 号：R453.2[医药卫生—治疗学]