慢性阻塞性肺病患者并发肺动脉高压的危险因素meta分析

Risk factors of complicating pulmonary hypertension in patients with chronicobstructive pulmonary disease:a meta-analysis

目的 系统评价慢性阻塞性肺疾病(COPD)患者并发肺动脉高压(PH)的危险因素。方法 通过计算机检索PubMed、Embase、Cochrane Library、维普、中国知网、中国生物医学文献服务系统和万方,检索时限为建库至2023年9月。收集COPD患者并发PH的危险因素文献,采用RevMan 5.3软件进行meta分析。结果 共纳入18篇文献,其中前瞻性研究8篇,回顾性研究10篇,共4 361例COPD患者,包含8个危险因素。meta分析结果显示,有统计学意义的危险因素包括C反应蛋白(CRP)[OR(95%CI)=2.17 (1.49~3.14)]、白细胞介素-6(IL-6)[OR(95%CI)=2.07(1.59~2.70)]、肿瘤坏死因子-α(TNF-α)[OR(95%CI)=1.69(1.28~2.22)]、脑钠肽(BNP)[OR(95%CI)=1.58(1.35~1.85)]、D-二聚体(D-D)[OR(95%CI)=2.58(1.99~3.35)]、1 s用力呼气容积(FEV1)[OR(95%CI)=2.49(1.93~3.20)]、平均血小板体积(MPV)[OR(95%CI)=1.69(1.19~2.39)]。结论 CRP、IL-6、TNF-α、BNP、D-D、FEV1、MPV是COPD患者并发PH的危险因素。

Objective To systematically evaluate the risk factors for complicating pulmonary hypertension(PH)in the patients with chronic obstructive pulmonary disease(COPD).Methods The databases of PubMed,Embase,Cochrane Library,VIP,CNKI,China Biomedical Literature Service System and Wanfang Database were retrieved by computer.The retrieval time limitation was from the establishment of the database to September 2023.The literatures on the risk factors for complicating PH in the patients with COPD was collected and the meta analysis was conducted by using the RevMan 5.3 software.Results A total of 18 articles were included,including 8 prospective studies and 10 retrospective studies,with a total of 4361 COPD patients,including 8 risk factors.The meta analysis results showed that the risk factors with statistical significance included C-reactive protein(CRP)[OR(95%CI)=2.17(1.49-3.14)],interleukin-6(IL-6)[OR(95%CI)=2.07(1.59-2.70)],tumor necrosis factor-α(TNF-α)[OR(95%CI)=1.69(1.28-2.22)],brain natriuretic peptide(BNP)[OR(95%CI)=1.58(1.35-1.85)],D-dimer(D-D)[OR(95%CI)=2.58(1.99-3.35)],forced expiratory volume in one second(FEV1)[OR(95%CI)=2.49(1.93-3.20)]and mean platelet volume(MPV)[OR(95%CI)=1.69(1.19-2.39)].Conclusion CRP,IL-6,TNF-α,BNP,D-D,FEV1 and MPV are the risk factors for complicating PH in COPD patients.