可吸入性颗粒物与儿童哮喘发病风险的Meta分析

发布时间：2018-02-13 21:53

  本文关键词： 可吸入颗粒物 儿童 哮喘 系统评价 Meta分析　出处：《重庆医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的定量分析大气可吸入性颗粒物(PM2.5,PM10)暴露对儿童哮喘发病风险的影响。方法计算机检索PubMed、EMBASE、Cochrane图书馆、Ovid、中国生物医学数据库、中国知网和万方数据库,检索时间均为建库至2014年11月,同时手工检索相关杂志,纳入可吸入颗粒物暴露与儿童哮喘关联的观察性研究文献。采用NOS和AHRQ量表进行文献偏倚评价。以可吸入性颗粒物每升高10 ug.m-3与儿童哮喘发病风险关联强度的OR及其95%CI作为效应量,按急性效应和慢性效应分别行Meta分析,进一步按PM2.5和PM10行亚组分析。采用Revman5.3和Stata12.0软件分别行异质性分析及发表偏倚检验,根据异质性分析结果采用相应的效应模型合并效应值。结果31篇文献进入Meta分析,队列研究10篇,横断面研究12篇,病例交叉研究8篇,时间序列研究2篇。(1)22篇文献报道了可吸入性颗粒对儿童哮喘发病风险的慢性效应,文献间具异质性(P≤0.1,I2=72%),随机效应模型的Meta分析结果显示,合并OR=1.10(95%CI:1.03~1.17),即大气PM2.5或PM10浓度每上升10 ug.m-3,儿童哮喘的发病风险升高10%;亚组分析显示,PM2.5和PM10合并的OR值分别为1.08(95%CI:1.02~1.15)和1.10(95%CI:1.01~1.20)。(2)9篇文献报道了可吸入性颗粒对儿童哮喘发病风险的急性效应,文献间具异质性(P≤0.1,I2=63%),随机效应模型的Meta分析结果显示,合并OR=1.05(95%CI:1.02-1.08),即大气PM2.5或PM10浓度每上升10ug.m-3,儿童哮喘的发病风险升高5%;亚组分析显示,PM2.5和PM10合并的OR值分别为1.06(95%CI:1.02~1.10)和1.05(95%CI:1.02~1.08)。(3)Egger直线回归法发表偏倚检验显示,急性效应不存在明显发表偏倚,慢性效应存在明显发表偏倚。结论PM2.5和PM10水平与儿童哮喘发病风险的急性和慢性效应存在显著关联。
[Abstract]:Objective to quantitatively analyze the effects of atmospheric inhalable particulate matter (PM2.5 / PM10) exposure on the risk of asthma in children. Methods A computer-based search was conducted for PubMedus EMBASE Cochrane Library Ovid, China Biomedical Database, China knowledge Network and Wanfang Database. The retrieval time is from the construction of the database to November 2014, and the relevant magazines are searched manually. To study the relationship between inhalable particulate matter exposure and childhood asthma. To evaluate the bias using NOS and AHRQ scales. OR was used to evaluate the correlation between inhalable particulate matter for every 10 ug.m-3 increase and the risk of asthma in children. And 95 CI as the effect quantity, Meta analysis was performed according to acute effect and chronic effect, and subgroup analysis was performed by PM2.5 and PM10. Heterogeneity analysis and publication bias test were performed by Revman5.3 and Stata12.0 software, respectively. Results 31 articles were included in Meta analysis, 10 were cohort studies, 12 were cross-sectional studies, 8 were cross-sectional studies, and 8 were cross-sectional studies. The chronic effects of inhalable granules on the risk of asthma in children were reported in 2 papers of time series study. The results of Meta analysis of random effect model showed that there was heterogeneity P 鈮，

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