儿童反复呼吸道感染影响因素的Meta分析

The Influencing Factors of Recurrent Respiratory Tract Infections in Children:A Meta-Analysis

目的通过Meta分析明确中国儿童反复呼吸感染(RRTIs)的影响因素。方法计算机检索Cochrane Library、PubMed、Embase、Web of Science、知网(CNKI)、万方数据库(WanFang Data)、维普数据库(VIP)和中国生物医学文献数据库(CBM),搜索与中国RRTIs影响因素的研究,检索时限从建库至2021年5月1日,结果采用RevMan 5.3软件进行Meta分析。结果共纳入16篇病例对照研究,包括6876例儿童。Meta分析结果显示:中国RRTIs的影响因素为被动吸烟(OR=1.95,95%CI 1.69~2.24,P<0.001)、住房类型(平房)(OR=6.70,95%CI 4.00~11.20,P<0.001)、与慢性呼吸疾病患者生活(OR=1.78,95%CI 1.18~2.68,P=0.006)、哮喘史(OR=2.39,95%CI 1.79~3.29,P<0.001)、过敏史(OR=1.84,95%CI 1.48~2.27,P<0.001)、佝偻病史(OR=4.33,95%CI 2.86~6.58,P<0.001)、粒细胞减少症(OR=2.91,95%CI 1.74~4.88,P<0.001)、变异性皮肤病史(OR=2.13,95%CI 1.41~3.22,P<0.001)、其他病因住院史(OR=6.28,95%CI 4.83~8.16,P<0.001)、早产史(OR=2.46,95%CI 2.07~2.92,P<0.001)、低出生体质量史(OR=2.80,95%CI 2.14~3.66,P<0.001)、Vit A缺乏(OR=5.06,95%CI 4.00~6.41),P<0.001)、Vit D缺乏(OR=4.40,95%CI 3.17~6.11,P<0.001)、Vit E缺乏(OR=3.43,95%CI 1.11~10.63,P=0.030)、母乳喂养(OR=0.57,95%CI 0.48~0.67,P<0.001)、厌食/偏食(OR=2.42,95%CI 1.94~3.02,P<0.001)、户外活动时间(<30 min/d)(OR=5.23,95%CI 4.00~6.84,P<0.001)和入托(OR=1.74,95%CI 1.10~2.75,P<0.001)。结论中国RRTIs可能与被动吸烟,住房类型(平房)与慢性呼吸疾病患者生活,哮喘史,过敏史,佝偻病史,粒细胞减少症,变异性皮肤病史,其他病因住院史,早产史,低出生体质量史,Vit A、D、E缺乏,厌食/偏食,户外活动时间(<30 min/d)和入托有关,母乳喂养是其保护因素。

Objective To determine the influencing factors of recurrent respiratory tract infections(RRTIs)in Chinese children by Meta-analysis.Methods Articles related with the influencing factos of Chinese RRTIs were identified through a search of Cochrane Library,PubMed,Embase,Web of Science,China National Knowledge Infrastructure(CNKI),WanFang Data,VIP,China Biomedical literature Database(CBM)form inception of there database to May 1,2021.Revman 5.3 software was used for Meta-analysis.Results A total of 16 case-control studies were included,including 6876 children.Meta-analysis results showed the influencing factors related to RRTIs in Chinese children included passive smoking(OR=1.95,95%CI 1.69~2.24,P<0.001),housing type(bungalow)(OR=6.70,95%CI 4.00~11.20,P<0.001),living with patients with chronic respiratory system disease(OR=1.78,95%CI 1.18~2.68,P=0.006),asthma(OR=2.39,95%CI 1.79~3.29,P<0.001),allergy(OR=1.84,95%CI 1.48~2.27,P<0.001),rickets(OR=4.33,95%CI 2.86~6.58,P<0.001)history of neutropenia(OR=2.91,95%CI 1.74~4.88,P<0.001),history of variant skin(OR=2.13,95%CI 1.41~3.22,P<0.001),history of hospitalization for other causes(OR=6.28,95%CI 4.83~8.16,P<0.001),preterm labor(OR=2.46,95%CI 2.07~2.92,P<0.001),low birth weight(OR=2.80,95%CI 2.14~3.66,P<0.001),Vitamin A insufficiency(OR=5.06,95%CI 4.00~6.41),P<0.001),Vitamin D insufficiency(OR=4.40,95%CI 3.17~6.11,P<0.001),Vitamin E insufficiency(OR=3.43,95%CI 1.11~10.63,P=0.030),breastfeeding(OR=0.57,95%CI 0.48~0.67,P<0.001),anorexia/paranoia(OR=2.42,95%CI 1.94~3.02,P<0.001),outside activity time(<30 min/d)(OR=5.23,95%CI 4.00~6.84,P<0.001),kindergarten attendance(OR=1.74,95%CI 1.10~2.75,P<0.001).Conclusion RRTIs in Chinese children are likely to be related to passive smoking,housing type(bungalow),living with patients with chronic respiratory system disease,asthma,allergy,rickets,history of neutropenia,history of variant skin,history of hospitalization for other causes,preterm labor,low birth weight,Vitamins A,D,E insufficiency,anorexia/paranoia,outside activity time(<30 min/d),kindergarten attendance,while breastfeeding is one of the protecting factors.