儿童反复呼吸道感染危险因素的Meta分析

Meta-analysis of risk factors for recurrent respiratory infections in children

目的探讨儿童反复呼吸道感染的危险因素。方法检索数据库建库至2020年6月国内外公开发表的儿童反复呼吸道感染危险因素的病例对照或队列研究文献,使用Stata 15.1及Review Manager 5.3软件进行数据统计分析。结果共纳入20篇符合文献,儿童反复呼吸道感染相关危险因素的合并OR值(95%置信区间)分别为:户外活动<2 h/d 3.62(2.87,4.56)、挑食偏食3.47(2.68,4.48)、入学入托3.45(2.49,4.78)、抗菌药物使用次数多3.00(2.41,3.74)、父亲/母亲文化程度低3.00(1.36,6.64)、微量元素缺乏(锌缺乏)2.94(2.23,3.89)、慢性呼吸道疾病暴露史2.84(1.97,4.07)、父母过敏史或过敏体质2.08(2.05,2.11)、被动吸烟1.72(1.43,2.08);母乳喂养0.58(0.46,0.74)、足期产0.35(0.27,0.44)。结论户外活动<2 h/d、挑食偏食、入学入托、抗菌药物使用次数多、父亲/母亲文化程度低、微量元素缺乏(锌缺乏)、慢性呼吸道疾病暴露史、父母过敏史或过敏体质及被动吸烟是儿童反复呼吸道感染的危险因素;缺乏户外活动对儿童反复呼吸道感染发病的危险程度最高,其次是挑食偏食及入学入托。母乳喂养、足期产是儿童反复呼吸道感染的保护因素。

OBJECTIVE To explore the risk factors of with recurrent respiratory tract infections in children.METHODS The database was searched for case-control or cohort study literature on the risk factors of children with recurrent respiratory tract infections published at home and abroad from the establishment of the database to June 2020,and statistical analysis was performed using Stata 15.1 and Review Manager 5.3 software.RESULTS A total of 20 articles were included.The combined OR values(95%confidence interval)of the risk factors for children with recurrent respiratory tract infections were:outdoor activities<2 h/d 3.62(2.87,4.56),picky eaters 3.47(2.68,4.48),enrollment in nursery school 3.45(2.49,4.78),frequent use of antibiotics 3.00(2.41,3.74),father/mother’s low education level 3.00(1.36,6.64),trace element deficiency(zinc deficiency)2.94(2.23,3.89),chronic respiratory tract disease exposure history 2.84(1.97,4.07),parental allergy or allergies 2.08(2.05,2.11),passive smoking 1.72(1.43,2.08);breastfeeding 0.58(0.46,0.74),full-term delivery 0.35(0.27,0.44).CONCLUSION Outdoor activities<2 h/d,picky eater,enrollment in nursery school,frequent use of antimicrobials,low education level of the father/mother,deficiency of trace elements(zinc deficiency),history of chronic respiratory disease exposure,history of parental allergies or allergies and passiveness smoking were risk factors for children’s recurrent respiratory infections;lack of outdoor activities had the highest risk of recurrent respiratory infections in children,followed by picky eaters and school attendance.Breastfeeding and full-term delivery were protective factors for children with recurrent respiratory infections.