与儿童失控喘相关的危险因素 - 一个系统性审查和元分析
Muhammad Imran Arif1, Liang Ru1, Yanan Wang1
1Department of Pediatrics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
概括
过去的过敏反应和控制器的不良坚持是儿童非控制性喘的关键危险因素. 解决这些问题可以改善儿科患者的喘管理和治疗结果.
科学领域:
- 儿科肺病学 儿科肺病学
- 过敏和免疫学 过敏和免疫学
- 流行病学 流行病学
背景情况:
- 喘是一种慢性呼吸道疾病,影响着全球数百万儿童和青少年.
- 儿童群体中不受控制的喘导致医疗保健利用率增加,生活质量降低,并可能导致长期肺损伤.
- 确定可修改的风险因素对于制定有效的预防和管理策略至关重要.
研究的目的:
- 系统地审查和分析与儿童和青少年不受控制的喘相关的风险因素.
- 确定在这个年龄组中显著增加控制不良喘的可能性的特定因素.
主要方法:
- 在主要的电子数据库 (PubMed/Medline,Cochrane Library,Google Scholar) 进行了系统的文献搜索,截至2023年7月17日.
- 十项观察性研究被纳入了元分析.
- 采用随机效应模型来汇集数据,将结果报告为标准化平均差异 (SMD) 与95%置信区间;用于非可量化的结果,使用叙事合成.
主要成果:
- 过去的过敏反应 (SMD = 1.51,p = 0.002) 和不完全的对照剂药物坚持 (SMD = 3.15,p < 0.0001) 与不受控制的喘有显著的关联.
- 父母喘病史 (SMD = 1.23,p = 0.07),口服皮质类固醇使用 (SMD = 0.99,p = 0.96) 和照顾者教育 (SMD = 0.99,p = 0.96) 没有显示出统计学上显著的关联.
- 对于过敏反应和控制器坚持观察到高异质性 (I2>80%).
结论:
- 过去的过敏反应和对控制剂药物的不良坚持是儿童和青少年非控制性喘的重要危险因素.
- 这些发现凸显了在临床实践中监测和解决这些特定因素的重要性.
- 进一步的研究可能会探索针对这些已识别的风险因素的干预措施,以改善儿童群体的喘控制.
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