我国极低出生体质量早产儿并发支气管肺发育不良危险因素的Meta分析

Meta-analysis of risk factors for bronchopulmonary dysplasia among very low birth weight infants in China

目的运用循证医学探讨我国极低出生体质量早产儿并发支气管肺发育不良的危险因素。方法系统检索Pub Med、Embase、万方数据库、中国期刊全文数据、中国知网(CNKI)、中文科技期刊全文数据、Cochrane临床对照试验资料库、中国生物医学文献数据库(CBM),检索时间均从建库至2016年5月。按纳入排除标准进行随机对照试验的筛选、资料提取和文献质量评价,应用Stata 11.0软件进行meta分析。结果共纳入15篇对照试验研究,mate分析结果显示,胎膜早破(OR=1.90,95%CI:1.16~3.11),肺透明膜病(OR=6.46,95%CI:4.47~9.35),吸氧时间(RR=3.01,95%CI:1.34~4.69),肺部感染(OR=15.76,95%CI:7.51~33.07),生后窒息(OR=2.23,95%CI:1.09~4.57),产前感染(OR=3.41,95%CI:2.40~4.84),动脉导管未闭(OR=3.39,95%CI:2.04~5.64),胎龄(RR=-2.34,95%CI:-3.42^-1.27),出生体质量(RR=-2.08,95%CI:-2.91^-1.21)是极低出生体质量早产儿并发支气管肺发育不良的危险因素;产后使用肺表面活性物质(OR=4.09,95%CI:1.65~10.12)是其保护因素。结论应积极对极低出生体质量早产儿并发支气管肺发育不良危险因素采取预防措施,从而降低支气管肺发育不良的发生率,提高生存率及改善远期生活质量。

Objective Using evidence-based medicine method to analyse the risk factors of bronchopulmonary dysplasia( BPD) among very low birth weight infants. Methods Pub Med,Embase,Wan-fang database,China journal full-text database and Chinese science and technology journal full-text database,the Cochrane controlled clinical trials database,Chinese biomedical literature database( CBM)were searched systematically from their establishment to May 2016. The quality of literature was evaluated and software Stata 11. 0 was used for a meta-analysis. Results Fifteen controlled trials were included in the study. Meta analysis showed premature rupture of membranes( OR = 1. 90,95% CI: 1. 16- 3. 11),pulmonary hyaline membrane disease( OR = 6. 46,95% CI: 4. 47- 9. 35),oxygen time( RR =3. 01,95% CI: 1. 34- 4. 69),and pulmonary infection( OR = 15. 76,95% CI: 7. 51- 33. 07),after birth asphyxia( OR = 2. 23,95%CI: 1. 09- 4. 57),prenatal infection( OR = 3. 41,95% CI: 2. 40- 4. 84),PDA( OR = 3. 39,95% CI: 2. 04- 5. 64),gestational age( RR = 2. 34,95% CI: 2. 34- 1. 27),birth weight( RR = 2. 08,95% CI: 2. 08- 1. 21) were risk factors of bronchial pulmonary dysplasia of VLBW infants; prenatal application of PS( OR = 4. 09,95% CI: 1. 65- 10. 12) was the protective factor. Conclusion Preventive measures should be taken to reduce the risk factors for BPD of VLBW infants to reduce the incidence of it and prolong the survival and improve the long-term quality of life.