儿童哮喘与1岁以内使用抗菌药物的关系的Meta分析

Association between use of antibacterial agents in the first year of life and childhood asthma: a Meta analysis

摘要:

目的 评估生后1 年内使用抗菌药物与儿童哮喘的关系。方法 检索中国知网数据库、中国维普科技期刊数据库、万方数据库、PubMed、EBSCO 等中英文数据库关于儿童哮喘与其1 岁以内使用抗菌药物的关系的前瞻性队列研究，采用Stata12.0 软件，通过Meta 分析方法探讨二者之间的关系。结果 选取文献质量评分高并且调整了下呼吸道感染因素的效应值进行合并，共纳入8 项研究。Meta 分析结果显示，1 岁以内抗菌药物的使用增加了儿童哮喘的风险（OR=1.14，95%CI：1.10~1.17，P < 0.05）；1 年内使用抗菌药物>4 次与使用0~1 次相比哮喘风险增加（OR=1.28，95%CI：1.19~1.38，P < 0.05）；高风险儿童（至少有1 位直系亲属曾患有哮喘）使用抗菌药物罹患哮喘的风险与其他儿童相比增加（OR=1.47，95%CI：1.20~1.81，P < 0.05）。结论 生后1 年内使用抗菌药物增加儿童哮喘的风险；高风险儿童使用抗菌药物增加哮喘的风险；抗菌药物使用次数增加与哮喘风险增加有关，但具体的剂量关系有待进一步研究。

Abstract:

Objective To evaluate the association between the use of antibacterial agents in the first years of life and childhood asthma. Methods The Chinese and English databases CNKI, Wanfang Data, VIP, PubMed, and EBSCO were searched for prospective cohort studies on the association between the use of antibacterial agents in the first years of life and childhood asthma. Stata12.0 software was used to analyze the association through a Meta analysis. Results The articles with a high quality score and adjusted effective values for factors for lower respiratory tract infection were pooled, and a total of 8 studies were included. The results of the Meta analysis showed that the use of antibacterial agents in the first years of life increased the risk of childhood asthma (OR=1.14, 95%CI: 1.10-1.17, P < 0.05). Compared with the children who used antibacterial agents 0-1 times in the first years of life, those who used more than 4 times had an increased risk of asthma (OR=1.28, 95%CI: 1.19-1.38, P < 0.05). High-risk children (at least one immediate family member had asthma) who used antibacterial agents had an increased risk of asthma (OR=1.47, 95%CI: 1.20-1.81, P < 0.05). Conclusions The use of antibacterial agents in the first years of life increases the risk of childhood asthma. High-risk children who use antibacterial agents have an increased risk of asthma. The increased frequency of use of antibacterial agents in the first years of life is associated with an increased risk of childhood asthma, but the detailed dose relationship needs further investigation.