青少年罹患流行性癔症特征比较的Meta分析

Meta-analysis on attack rate of epidemic hysteria in children and adolescents

目的分析评估中外青少年罹患流行性癔症（EH）特征的差异。方法采用文献综述和比较分析的方法收集和整理数据,通过描述性分析和Meta分析的方法评估青少年EH罹患率的流行病学特征,罹患率的计算采用纳入研究各罹患率组合加权方法,采用R软件3.2.0提供的随机效应模型估计青少年EH合并罹患率。结果 54篇文献（N=100 617人）被纳入Meta分析,5 789名青少年罹患EH。54篇研究文献质量评估均为中上等。中国青少年EH总罹患率[15.3%,95%CI（0.115~0.200）,P〈0.000 1]比国外[11.8%,95%CI（0.094~0.144）,P〈0.000 1]高,中外青少年EH的流行病学特征罹患率范围分别为5.4%~31.8%、5.6%~31.9%;不同特征罹患率比较分析,除了高中、小学、大气污染和春季的青少年EH罹患率低于国外,其他特征的EH罹患率均是中国青少年高于国外青少年。结论中外青少年罹患EH的流行特征存在差异,青少年EH发生可能与生活方式、教育模式、社会心理和文化因素以及社会人口学背景等因素关联。

Objective To analyze the difference of attack rate of epidemic hysteria（EH）among children and adolescents in China and other countries. Methods Data were obtained through literature review and were analyzed comparatively.A descriptive epidemiological method and meta-analysis were used to assess the attack rates（ARs）.Attack rate（AR）was calculated as the aggregate means weighted by the adjustment of subject number in the chosen studies.The Meta AR of EH was estimated using the random effect model provided by R3.2.0version software. Results Fifty-four articles（N=100 617）were retrieved for the analysis with a total 5 789 cases reported.All articles had a high to moderate methodological quality.The overall attack rate of EH was higher（15.3%,95%CI：0.115-0.200）among children in China than those from other countries（11.8%,95%CI：0.094-0.144）,（P0.000 1）.The ARs of EH ranged from 5.4% to 31.8%in China,and from 5.6%to 31.9%in other countries.The comparative analysis showed that the ARs were lower among children from elementary and high schools,and from air polluted areas as well as in spring in China compared to those from other countries. Conclusions The AR of EH varies among children from China and abroad which may be related to lifestyle,education,psychosocial and cultural factors as well as sociological and demographic backgrounds.