慢性阻塞性肺疾病危险因素的Meta分析

A Meta-analysis of risk factors for chronic obstructive pulmonary disease

背景:慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)是医学界健康焦点,早期评估和干预相关危险素可以预防疾病进展和提高临床疗效。目的:了解与COPD发展相关的风险因素非常重要,是唯一能减轻全球负担的成本效益高的公共卫生干预策略。方法:系统检索PubMed、The Cochrane Library、EMbase、中国知网、维普、万方、中国生物医学文献中国数据库等,搜集有COPD的相关危险因素的研究,检索时限建库以来至2022年3月的病例对照研究。由2名研究者独立筛选文献,提取资料并进行偏倚风险评价,定量综合分析国内外有关COPD发病主要危险因素的研究结果,运用RevMan5.4进行一致性检验及合并OR值和95%CI计算。结果:共纳入8篇文献,Meta分析结果显示:烟龄>20年OR=1.88,95%CI(1.44~2.47);年龄OR=1.97,95%CI(1.08~3.59);吸烟OR=1.45,95%CI(1.20~1.75),身体质量指数OR=1.17,95%CI(0.53~2.61);反复呼吸道感染OR=2.32,95%CI(1.28~4.21);呼吸疾病家族史OR=4.86,95%CI(2.06~11.51);性别OR=1.05,95%CI(0.70~1.58);职业暴露OR=4.96,95%CI(0.90~27.43)。结论:男性、高龄、吸烟、职业暴露、身体质量指数(肥胖)、反复呼吸道感染、呼吸疾病家族史是目前人群COPD发病的危险因素。但受纳入研究数量和质量的限制,尚待更多大样本、高质量的研究进一步验证。

Background:Chronic obstructive pulmonary disease(COPD)is a significant health and economic burden in the AsiaPacific region and around the world,and it is the focus of the medical community.Early assessment and intervention of related risk factors can prevent disease progression and improve clinical outcomes.Objective:Understanding the risk factors associated with the development of COPD is important and represents the only cost-effective public health intervention strategy that can reduce the global burden.Methods:PubMed,The Cochrane Library,EMmbase,CNKI,VIP,Wangfang and SinoMed were systematically searched to collect studies on COPD-related risk factors,and the search period was limited to case-control studies from the database establishment to March 2022.Two researchers independently screened the literature,extracted the data,and assessed the risk of bias,and quantitatively and comprehensively analyzed the research results of the main risk factors for COPD at home and abroad.Conformance check and OR and 95%CI calculations are performed using RevMan 5.4.Results:A total of 8 literatures were included.Meta-analysis showed that OR=1.88,95%CI(1.44~2.47)for smoking age more than 20 years,OR=1.97,95%CI(1.08~3.59)for age;OR=1.45,95%CI(1.20~1.75)for smoking;OR=1.17,95%CI(0.53~2.61)for body mass index(BMI);OR=2.32,95%CI(1.28~4.21)for recurrent respiratory tract infection;OR=4.86,95%CI(2.06~11.51)for family history of respisatory diseases;OR=1.05,95%CI(0.70~1.58)for gender;OR=4.96,95%CI(0.90-27.43)for occupational exposure.Conclusion:Male,advanced age,smoking,smoking age of more than 20 years,occupational exposure,obesity,recurrent respiratory tract infection,and family history of respiratory diseases are the risk factors of COPD in the current population.However,due to the limitation of the quantity and quality of included studies,more large-sample,high-quality studies are yet to be further verified.