摘要
目的:系统评价婴幼儿毛细支气管炎后喘息的危险因素。方法:检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普数据库(VIP)、万方数据库(WanFang Database)、PubMed、EMbase、Web of Science等数据库,搜集婴幼儿毛细支气管炎后喘息危险因素的病例-对照研究和队列研究,检索时限均从建库至2022年1月31日。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4.1软件进行Meta分析。结果:共纳入13项队列研究,涉及毛细支气管炎患儿2 887例。Meta分析结果显示:患儿出生体质量大于4 kg[OR=2.25,95%CI(1.22,4.16),P=0.010]、母乳喂养[OR=0.69,95%CI(0.49,0.99),P=0.04]、过敏性疾病家族史[OR=2.67,95%CI(1.44,4.95),P=0.002]、哮喘家族史[OR=2.13,95%CI(1.03,4.40),P=0.04]、湿疹[OR=2.30,95%CI(1.82,2.91),P<0.000 01]、烟草暴露[OR=2.73,95%CI(1.55,4.82),P=0.000 5]、特应质[OR=5.71,95%CI(3.24,10.06),P<0.000 01]、病情严重程度[OR=2.39,95%CI(1.35,4.25),P=0.003]、牛奶蛋白阳性[OR=5.18,95%CI(1.93,13.87),P=0.001]、肺纹理增粗[OR=2.04,95%CI(1.10,3.77),P=0.02]均是婴幼儿毛细支气管炎后喘息的危险因素。结论:当前证据显示,患儿出生体质量大于4 kg、母乳喂养、过敏性疾病家族史、哮喘家族史、湿疹、烟草暴露、特应质、病情严重程度、牛奶蛋白阳性、肺纹理增粗是婴幼儿毛细支气管炎后喘息的危险因素。临床医护人员应针对具有以上危险因素的高危人群加强防护和管理,以降低毛细支气管炎后喘息的发生。
Objective:To systematically evaluate the risk factors of wheezing after bronchiolitis in infants.Methods:The case-control study and cohort study on the risk factors of asthma after bronchiolitis in infants were retrieved from CNKI,CBM,VIP,WanFang Database,PubMed,EMbase,Web of Science and other databases.The retrieval time limit was from the establishment of the database to January 31,2022.After two evaluators independently screened the literature,extracted the data and evaluated the risk of bias included in the study.RevMan 5.4.1 software was used for Meta-analysis.Results:A total of 13 cohort studies were included,involving 2887 children with bronchiolitis.The results of Meta-analysis showed that the birth weight of the infant was more than 4 kg[OR=2.25,95%CI(1.22,4.16),P=0.010],breast feeding[OR=0.69,95%CI(0.49,0.99),P=0.04],family history of allergic disease[OR=2.67,95%CI(1.44,4.95),P=0.002],family history of asthma[OR=2.13,95%CI(1.03,4.40),P=0.04],eczema[OR=2.30,95%CI(1.82,2.91),P<0.00001],tobacco exposure[OR=2.73,95%CI(1.55,4.82),P=0.0005],atopy[OR=5.71,95%CI(3.24,10.06),P<0.00001],severity of the disease[OR=2.39,95%CI(1.35,4.25),P=0.003],positive milk protein[OR=5.18,95%CI(1.93,13.87),P=0.001],and thickening of lung markings[OR=2.04,95%CI(1.10,3.77),P=0.02]were all risk factors for asthma after bronchiolitis.Conclusion:The current evidence shows that the risk factors of asthma after bronchiolitis in infants are the birth weight of infants greater than 4 kg,breastfeeding,family history of allergic diseases,family history of asthma,eczema,tobacco exposure,atopy,severity of disease,positive milk protein,and thickening of lung markings.Clinical medical staff should strengthen protection and management for high-risk groups with the above risk factors to reduce the occurrence of post-bronchiolitis wheezing.
作者
高梦希
程侣
GAO Mengxi;CHENG Lyu(Shaanxi Energy Institute,Shaanxi 710613 China)
出处
《循证护理》
2023年第11期1901-1907,共7页
Chinese Evidence-Based Nursing
基金
2021年度陕西省职业技术教育学会立项课题,编号:2021SZXYB10。
