PM2．5浓度与儿童哮喘急性发作相关性的Meta分析

The association between concentration of particulate matt（PM2.5） and asthma attack in children： a Meta - analysis

目的评价大气颗粒物（PM2．5）浓度对儿童哮喘急性发作的影响。方法计算机以“Asthma”为主题词结合自由词对哮喘进行检索，以“Child”为主题词并结合自由词“Child＊”、“Pediatric＊”等对儿童进行检索，以“PM2．5”、“ParticulateMatter＋”等为自由词对PM2．5进行检索，三者以逻辑关系“AND”连接，检索PubMed、Medline等英文数据库；以“哮喘”AND（“儿童”OR“儿科”OR“幼儿”等）AND（“PM2．5”OR“大气颗粒物”OR“可吸入颗粒物”等）为关键词对CBM、中国知网、维普和万方等数据库进行主题检索，检索年限从建库至2014年12月，同时辅以手工检索，依据纳入排除标准筛选文献，并通过Newcastle—OttawaScale量表对纳入文献的人群选择、可比性和结果评价3个方面进行方法学质量评价。Revman5．3和Statal2．0软件对最终纳入的文献进行统计分析、异质性检验、敏感性分析和亚组分析等。结果最终纳入17篇文献，研究对象为1326573例。文献质量评价结果是8分2篇，7分2篇，6分7篇，5分5篇，4分1篇。Meta分析结果显示PM2．5浓度与儿童哮喘急性发作的比值比（OR）=1．06，95％置信区间（CI）1．03～1．08。其中，结局指标亚组分析显示，OR就诊^数=1．03，95％CI1．01～1．06，OR￡作《状=1．11，95％CI1．06～1．16；发达发展中国家亚组分析显示OR＆月十目家=1．04，95％CI1．02～1．06，OR≈达目i：1．06，95％CI1．03～1．09。结论PM2．5浓度增加会提高儿童哮喘急性发作及哮喘就诊的危险度。

Objective To evaluate the association between the concentration of particulate matter （ PM2.5 ） and asthma attack in children. Methods The computer and databases were used to search the key words ＂ Asthma＂ and ＂ Child＂ were searched by means of the subject headings （ ＂ Asthma＂ and ＂ Child＂） and free words （ ＂Asthma ＊ ＂ ,＂ Child ＊ ＂ and ＂Pediatric ＊ ＂etc. ） , moreover ＂PM2.5＂ was searched on the basis of free words such as ＂PM2.5＂ , ＂ Particulate Matter ＊ ＂ , which were linked with ＂ AND＂ in PubMed and Medline database. Further- more, the key words ＂asthma＂ AND （ ＂ Child＂ OR ＂Pediatric＂ OR ＂Infant＂ ） AND （ ＂PM2.5＂ OR ＂Particulate Mat- ter＂ OR ＂Inhalable Particles＂ ） for keywords were searched in CBM, CNKI, VIP and Wanfang databases. The literatures included those from the initial computer database up to those of December 2014 from computer database. Meanwhile manual research was added to screen literatures according to the standards of inclusion and exclusion. Newcastle - Ot- tawa Scale was employed to assess the quality of the included literatures including selection, comparability and out- come. Data were synthesized and analyzed by RevmanS. 3 and Statal2.0 version for statistical analysis, heterogeneity test, sensitivity analysis, subgroup analysis, and so on. Results A total of 17 literatures involving 1 326 573 children were included. The findings from quality assessment involved 2 studies for 8 scores, 2 for 7 scores, 7 for 6 scores, 5 for 5 scores, and 1 for 4 scores, respectively. The result of Meta -analysis showed that the combined the odds ratio （OR） of PM2.5 with childhood asthma attack was 1.06, and 95% confidence interval（CI） was 1.03 - 1.08. Sub- ~oup analysis showed that the OR on the asthma hospital visit equaled to 1.03 （95% CI 1.01 - 1.06）, and the OR an the asthma symptom equaled to 1.11 （95% CI 1.06 - 1.16） , moreover, subgroup analysis between developed and developing countries showed that the OR of the asthma on developing countries corresponded to 1.04 （95% CI 1.02 - 1.06） , and the OR of the asthma on developed countries corresponded to 1.06 （95% CI 1.03 - 1.09）. Conclusion Fhere is a positive correlation between concentration of PM2.5 and asthma attack in children.