空气污染物暴露联合运动锻炼对肺功能影响的Meta分析

Combined effect of air pollutant exposure and exercise on lung function:a Meta⁃analysis

目的:系统评价空气污染物暴露联合运动锻炼对肺功能的影响。方法:检索中国知网(CNKI)、Web of Science、PubMed、EBSCO、The Cochrane Library数据库,根据文献筛选标准筛选文献,提取文献资料,采用质量指数进行文献质量评价,并采用Stata 12.0软件进行Meta分析。结果:纳入19篇文献。Egger线性回归分析结果显示,纳入文献不存在发表偏倚。文献敏感性分析显示,用力肺活量(FVC)和1 s用力呼气量(FEV1)文献敏感性较低,而呼气峰流速(PEF)和呼出气一氧化氮(FeNO)存在文献敏感性问题。剔除敏感性文献后进行合并效应分析,结果显示,空气污染物暴露能够提高运动锻炼人群的FeNO水平[SMD=0.32,95%CI(0.11,0.53),P=0.003]。单因素Meta回归分析结果显示,空气污染物特征是研究间异质性的来源(回归系数为-0.779,P=0.022)。结论:现有证据表明,空气污染物暴露联合运动锻炼能够提高FeNO水平,影响机体肺功能。

Objective:To systematically evaluate combined effect of air pollutant exposure and exercise on lung function.Methods:Literatures were retrieved from CNKI,Web of Science,PubMed,EBSCO and The Cochrane Library.Relevant literatures were screened according to literature standard.Data of literatures were extracted,quality of literatures were evaluated by Quality Index.And Stata 12.0 software was used for Meta⁃analysis.Results:A total of 19 literatures were included.Egger's linear regression analysis showed that there was no publication bias in the included literatures.Literature sensitivity analysis showed that literatures related to forced vital capacity(FVC)and forced expiratory volume in the first second(FEV1)had low sensitivity,while those related to peak expiratory flow(PEF)and fractional exhaled nitric oxide(FeNO)had literature sensitivity issues.After sensitive literatures excluded,the combined effect analysis was carried out.The results showed that air pollutant exposure could increase FeNO level of exercise population[SMD=0.32,95%CI(0.11,0.53),P=0.003].The results of single⁃factor Meta regression analysis showed that pollution characteristics were sources of heterogeneity among studies(regression coefficient was-0.779,P=0.022).Conclusions:Existing evidence shows that air pollutant exposure and exercise can increase FeNO level and affect lung function.