尘肺病常见并发症发生情况的Meta分析

The prevalence of common complications among pneumoconiosis patients:a systematic review and Meta-analysis

目的分析尘肺病患者主要并发症类型及并发症发生率情况,为尘肺病防治工作提供科学依据。方法于2023年1月,系统检索中国期刊全文数据库(CNKI)、万方数据库和维普中文科技期刊全文数据库(VIP)、PubMed和Web of Science中2022年12月31日以前发表的关于尘肺病并发症的文献,按照纳入及排除标准选择文献,提取相关数据。采用研究质量评估工具进行文献质量评价。采用R 4.1.1软件计算合并的尘肺病患者并发症的检出率。采用亚组分析探索异质性来源。结果从2276篇尘肺病及其并发症相关文献中最终筛选出64篇纳入研究,尘肺病合并并发症的检出率为21.1%(95%CI:16.0%~26.3%,I2=99.9%)。在检出的不同类型并发症中,尘肺病合并慢性阻塞性肺部疾病(COPD)的检出率最高,为26.4%(95%CI:17.3%~35.6%,I2=97.1%)。亚组分析结果显示,壹期、贰期、叁期尘肺病合并肺结核的检出率分别为13.8%(95%CI:10.5%~17.2%,I2=99.6%)、18.4%(95%CI:14.9%~22.0%,I2=99.3%)和37.3%(95%CI:30.7%~44.0%,I2=99.1%),呈上升趋势(P<0.05);煤工尘肺合并肺结核的检出率为12.9%(95%CI:6.4%~19.3%,I2=97.9%),矽肺合并肺结核的检出率为13.9%(95%CI:10.0%~17.8%,I2=96.9%)。结论尘肺病患者合并不同类型并发症的检出率较高,且并发症检出率随着尘肺病严重程度而升高。

Objective To analysis the main types and prevalences of complications among pneumoconiosis patients,and to provide scientific basis for the prevention and treatment of pneumoconiosis.Methods In January 2023,literatures on pneumoconiosis complications published before December 31,2022 in China National Knowledge Infrastructure(CNKI),Wanfang Database,Chinese Science&Technology Journal Database(VIP),PubMed and Web of Science were systematically searched.Literatures were selected according to inclusion and exclusion criteria,and relevant data were extracted.Quality assessment tool was used to evaluate the quality of the articles for this study.The combined prevalence of complications among pneumoconiosis patients was calculated by R 4.1.1 software.Subgroup analysis was carried out to explore the origin of heterogeneity.Results Sixty-four eligible articles were selected from 2276 literatures related to pneumoconiosis and its complications.The combined prevalence of complications among pneumoconiosis patients was 21.1%(95%CI:16.0%-26.3%,I2=99.9%).The combined prevalence of chronic obstructive pulmonary disease(COPD)was 26.4%(95%CI:17.3%-35.6%,I2=97.1%),which was the highest among different types of complications among pneumoconiosis patients.Subgroup analyses revealed that the combined prevalence of tuberculosis among pneumoconiosis stageⅠ,ⅡandⅢwere 13.8%(95%CI:10.5%-17.2%,I2=99.6%),18.4%(95%CI:14.9%-22.0%,I2=99.3%)and 37.3%(95%CI:30.7%-44.0%,I2=99.1%),respectively,showing a corresponding increasing tendency(P<0.05).The combined prevalence of tuberculosis among coal worker's pneumoconiosis patients was 12.9%(95%CI:6.4%-19.3%,I2=97.9%),while the combined prevalence of tuberculosis among silicosis patients was 13.9%(95%CI:10.0%-17.8%,I2=96.9%).Conclusion The prevalence of pneumoconiosis patients combined with different types of complications is high,and its prevalence increases with the severity of pneumoconiosis.