戒烟干预对慢性阻塞性肺疾病患者肺功能变化的Meta分析

Smoking Cessation Intervention on the Changes of Pulmonary Function in Patients with COPD:A Meta-Analysis

目的 探讨戒烟干预下慢性阻塞性肺疾病(COPD)患者的肺功能变化情况,以提高患者和有关人员对COPD的认识,为开展戒烟干预提供科学的参考依据。方法 检索中国知网、万方数据库、中国生物医学文献服务系统、维普中文科技期刊数据库等中文数据库和PubMed等英文数据库,收集从建库至2022年3月的相关文献。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用RevMan 5.4.1软件进行统计分析。结果 共检索到相关文献1 623篇,最终纳入文献16篇,总样本量为1 469例,试验组722例,对照组747例。Meta分析结果显示,与对照组相比,戒烟对COPD患者FEV1、FVC有提高作用,其中FEV1合并效应具有统计学意义[P<0.000 01,SMD=0.91,95%CI(0.50~1.33)];FVC合并效应具有统计学意义[P<0.000 01,SMD=0.62,95%CI(0.43~0.82)];FEV1%Pred合并效应无统计学意义[P=0.34,SMD=7.23,95%CI(-7.75~22.22)]。结论 不同的戒烟干预均可提升COPD患者的肺功能,但仍需结合不同人群特点选择最优的戒烟方式,以持续改善肺功能。

Objective To investigate the changes of pulmonary function in patients with COPD under the intervention of smoking cessation,thus improving the understanding of COPD among patients and relevant personnel and providing scientific reference for smoking cessation intervention.Methods CNKI,Wanfang Data,CBM,VIP and PubMed databases were searched to collect studies on smoking cessation and COPD from inception to March 2022.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Meta-analysis was then performed using RevMan 5.4.1 software.Results A total of 1623 relevant studies were retrieved,and 16 studies were finally included.A total of 1469 subjects were included,with 722 subjects in the trial group and 747 subjects in the control group.Meta-analysis results showed that smoking cessation significantly increased FEV1 and FVC in COPD patients compared with the control group.The combined effect of FEV1 was statistically significant[P<0.00001,SMD=0.91,95%CI(0.50-1.33)];FVC merger effect was statistically significant[P<0.00001,SMD=0.62,95%CI(0.43-0.82)];the combined effect of FEV1%Pred was not statistically significant[P=0.34,SMD=7.23,95%CI(-7.75-22.22)].Conclusion Different smoking cessation interventions can improve the pulmonary function of COPD patients.It is still necessary to take into account the characteristics of different populations to choose the optimal cessation method and achieve sustained improvement in lung function.