毛细支气管炎后继发支气管哮喘危险因素的Meta分析

Meta-analysis of the risk factors of bronchiolitis developing to bronchial asthma in China

目的综合探讨我国毛细支气管炎患儿继发支气管哮喘的危险因素。方法全面检索Pub Med、万方数据库、中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普信息网等,搜索时间从建库至2017年1月。收集有关毛细支气管炎发展为支气管哮喘的危险因素的研究文献。按照纳入及排除标准,对符合要求的文献提取数据,应用STATA 12.0软件进行Meta分析。结果总共纳入文献12篇,Meta分析结果显示,被动吸烟(OR=6.84,95%CI:4.48~10.44)、特应性体质(OR=6.93,95%CI:4.56~0.52)、重症毛细支气管炎(OR=4.81,95%CI:2.89~8.02)、肥胖(OR=5.67,95%CI:2.96~10.86)、哮喘家族史(OR=14.45,95%CI:8.61~24.24)、下呼吸道感染(OR=12.66,95%CI:3.52~45.60)是毛细支气管炎发展为支气管哮喘的危险因素;母乳喂养>4个月龄(OR=5.31,95%CI:2.75~10.25)是其保护因素。结论针对毛细支气管炎发展为支气管哮喘的危险因素应采取预防性措施,鼓励母乳喂养时间至少4个月龄可以防治其发生,从而降低支气管哮喘的发生率。

Objective To synthetically evaluate the risk factors of bronchiolitis developing to bronchial asthma in China. Method Pub Med,Wan-fang database,CNKI,CBM and VIP were searched systematically from their establishment to January 2017. The quality of literature was evaluated according to the inclusion and exclusion criteria and software STATA 12. 0 was used for a meta-analysis. Results Twelve studies were selected. Meta-analysis showed second-hand smoking（ OR = 6. 84,95% CI： 4. 48-10. 44）,atopic status（ OR =6. 93,95% CI： 4. 56-0. 52）,severe bronchiolitis（ OR = 4. 81,95% CI： 2. 89-8. 02）,overweight（ OR = 5. 67,95% CI： 2. 96-10. 86）,family asthma history（ OR = 14. 45,95% CI： 8. 61-24. 24）,lower respiratory tract infection（ OR = 12. 66,95% CI： 3. 52-45. 60） were risk factors of bronchiolitis developing to bronchial asthma. Breastfeeding exceeding 4 months（ OR = 5. 31,95% CI： 2. 75-10. 25） was the protective factor. Conclusion Preventive methods should be taken to reduce the risk of bronchial asthma after bronchiolitis and advocate breastfeeding.