类风湿关节炎相关间质性肺病风险因素的Meta分析

Meta-analysis of risk factors for rheumatoid arthritis related interstitial lung disease

目的通过Meta分析系统评价类风湿关节炎相关间质性肺病(RA-ILD)的风险因素。方法计算机检索Cochrane Library、PubMed、Embase、Web of Science、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、万方科技期刊全文数据库,搜集与RA-ILD风险因素相关的所有研究,检索时限为建库至2023年1月。采用纽卡斯尔-渥太华量表(NOS)对纳入研究进行质量评价。由2名作者独立提取有关数据,采用固定或随机效应模型合并效应量。通过R软件实现Meta分析、亚组分析和敏感性分析;采用Stata12.0软件进行Egger's检验评估发表偏倚。结果共纳入15篇文献。Meta分析结果显示:男性[比值比(OR)=1.78,95%CI(1.39,2.27),P<0.001]、高龄[均数差(MD)=5.26,95%CI(2.67,7.84),P<0.001]、类风湿性关节炎(RA)病程长[MD=1.43,95%CI(0.34,2.53),P=0.01]、RA发病时年龄大[MD=5.52,95%CI(1.78,9.25),P=0.004]、吸烟[OR=1.59,95%CI(1.11,2.29),P=0.01]、类风湿因子(RF)阳性[OR=1.74,95%CI(1.46,2.07),P<0.001]、抗环瓜氨酸肽(CCP)抗体阳性[OR=1.48,95%CI(1.22,1.80),P<0.001]是RA-ILD发生的风险因素。结论男性、高龄、RA病程长、RA发病时年龄大、吸烟、RF阳性和抗CCP抗体阳性是RA-ILD发生的风险因素。

Objective To systematically evaluate the risk factors of rheumatoid arthritis related interstitial lung disease(RA-ILD)by Meta-analysis.Methods The Cochrane Library,PubMed,Embase,Web of Science,Chinese Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI)and Wanfang science and technology journal full-text database were searched by computer to collect all studies related to RA-ILD risk factors,and the retrieval time limit was from the establishment of the database to January 2023.The Newcastle-Ottawa Scale(NOS)was used to evaluate the quality of the included studies.The relevant data were extracted independently by two authors,and the fixed or random effect model was used to combine the effect size.Meta-analysis,subgroup analysis and sensitivity analysis were performed by R software;Egger's test was used to evaluate publication bias using Stata12.0 software.Results A total of 15 articles were included.The results of Meta-analysis showed that male[odds ratio(OR)=1.78,95%CI(1.39,2.27),P<0.001],older age[mean difference(MD)=5.26,95%CI(2.67,7.84),P<0.001],longer course of rheumatoid arthritis(RA)[MD=1.43,95%CI(0.34,2.53),P=0.01],older age at onset of RA[MD=5.52,95%CI(1.78,9.25),P=0.004],smoking[OR=1.59,95%CI(1.11,2.29),P=0.01],positive rheumatoid factor(RF)[OR=1.74,95%CI(1.46,2.07),P<0.001],positive anti-cyclic citrullinated peptide(CCP)antibody[OR=1.48,95%CI(1.22,1.80),P<0.001]were risk factors for RA-ILD.Conclusion Male,old age,long course of RA,old age at onset of RA,smoking,positive RF and positive anti-CCP antibody were risk factors for RA-ILD.