肺癌化疗患者发生肺部感染危险因素的Meta分析

Risk factors for pulmonary infection in patients with lung cancer after chemotherapy:A Meta-analysis

目的系统评价肺癌患者化疗后发生肺部感染的危险因素。方法系统检索中国知网、万方、维普、PubMed、Embase和the Cochrane Library从建库至2022年10月公开发表的有关肺癌患者化疗后发生肺部感染的危险因素的病例对照研究和队列研究。由2名研究者独立进行文献筛选、资料提取和质量评价,采用Rev Man 5.3软件进行Meta分析。结果共纳入15篇文献,3960例肺癌化疗患者。Meta分析结果显示,年龄≥60岁、吸烟史、饮酒史、高血压、糖尿病、肺不张、低蛋白血症、TNM分期为Ⅲ~Ⅳ期、中央型肺癌、小细胞肺癌、侵入性操作、化疗前卡氏功能状态评分<80分、联合使用化疗药物、化疗时间>2周、化疗后白细胞计数≤3.0×10^(9)/L、化疗后白蛋白<30g/L和住院天数>20d均是肺癌患者化疗后肺部感染的危险因素(P<0.05)。结论肺癌化疗患者发生肺部感染的危险因素较多,应依据其相关危险因素采取预防与控制措施,减少肺部感染的发生。

Objective To systematically evaluate the risk factors for pulmonary infection in patients with lung cancer after chemotherapy.Methods CNKI,Wanfang Data,VIP,PubMed,Embase,and the Cochrane Library were searched from inception to October 2022 to collect case-control studies and cohort studies about risk factors for pulmonary infection in patients with lung cancer after chemotherapy.Two researchers independently conducted literature screening,data extraction,and quality assessment.Rev Man 5.3 software was used for Meta-analysis.Results A total of 15 literatures were included,including 3960 patients with lung cancer after chemotherapy.Meta analysis results showed that age≥60 years,smoking history,drinking history,hypertension,diabetes mellitus,atelectasis,hypoproteinaemia,TNM staging of stageⅢ-Ⅳ,central lung cancer,small cell lung cancer,invasive operation,Karnofsky performance status score˂80 points before chemotherapy,combined chemotherapy drugs,duration of chemotherapeutic˃2 weeks,white blood cell count≤3.0×10^(9)/L after chemotherapy,albumin˂30g/L after chemotherapy,and hospital stay>20 days were risk factors for pulmonary infection in patients with lung cancer after chemotherapy(P˂0.05).Conclusion There were many risk factors for pulmonary infection in patients with lung cancer after chemotherapy.Prevention and control measures should be taken based on the related risk factors to reduce the incidence rate of pulmonary infection.