中国儿童哮喘危险因素的Meta分析

A Meta analysis of risk factors for asthma in Chinese children

摘要:

目的 探讨中国儿童哮喘的主要危险因素，为哮喘的防治提供参考依据。方法 系统收集中国知网、万方数据库、中国生物医学文献数据库、维普中文科技期刊全文数据库、Web of Science和PubMed等数据库从建库至2017年9月有关中国儿童哮喘危险因素的研究。采用Stata 12.0软件进行Meta分析。结果 共纳入24篇病例对照研究，其中病例组5 309例，对照组6 404例。Meta分析显示，家族哮喘史（OR=5.246，95% CI：3.435~8.011）、家族过敏史（OR=4.627，95% CI：2.450~8.738）、特应性体质（OR=4.659，95% CI：2.511~8.644）、变应性鼻炎（OR=11.510，95% CI：6.769~19.574）、湿疹/皮炎史（OR=4.919，95% CI：3.514~6.886）、患儿过敏史（OR=4.732，95% CI：2.802~7.989）、食物过敏史（OR=5.890，95% CI：3.412~10.166）、药物过敏史（OR=4.664，95% CI：2.637~8.252）、家中有霉斑（OR=2.483，95% CI：1.671~3.690）、家中种花草（OR=1.748，95% CI：1.383~2.209）、房屋装修史（OR=2.823，95% CI：2.206~3.935）、剖宫产（OR=1.894，95% CI：1.166~3.077）是儿童哮喘的危险因素，母乳喂养是儿童哮喘的保护因素（OR=0.508，95% CI：0.396~0.653）。结论 中国儿童哮喘的发生与多种因素有关，其中家族哮喘史、家族过敏史、个体特应性体质、过敏史、过敏合并症、剖宫产出生及不良的家庭环境因素可增加儿童哮喘的患病风险，而母乳喂养可降低儿童哮喘的患病风险。

Abstract:

Objective To investigate the main risk factors for asthma in Chinese children, and to provide a reference for the prevention and treatment of asthma. Methods The databases including CNKI, Wanfang Data, China Biology Medicine disc, VIP Database for Chinese Technical Periodicals, Web of Science, and PubMed were searched for studies on risk factors for asthma in Chinese children published up to September 2017. Stata 12.0 was used for the Meta analysis. Results A total of 24 case-control studies were included, with 5 309 cases in the case group and 6 404 cases in the control group. The Meta analysis showed that a family history of asthma (OR=5.246, 95% CI:3.435-8.011), a family history of allergy (OR=4.627, 95% CI:2.450-8.738), atopic constitution (OR=4.659, 95% CI:2.511-8.644), allergic rhinitis (OR=11.510, 95% CI:6.769-19.574), a history of eczema/dermatitis (OR=4.919, 95% CI:3.514-6.886), a history of allergies (OR=4.732, 95% CI:2.802-7.989), a history of food allergies (OR=5.890, 95% CI:3.412-10.166), a history of drug allergies (OR=4.664, 95% CI:2.637-8.252), mold contamination at home (OR=2.483, 95% CI:1.671-3.690), flowers at home (OR=1.748, 95% CI:1.383-2.209), a history of house decoration (OR=2.823, 95% CI:2.206-3.935), and cesarean section (OR=1.894, 95% CI:1.166-3.077) were risk factors for asthma in children, while breastfeeding was a protective factor against asthma (OR=0.508, 95% CI:0.396-0.653). Conclusions The development of asthma in Chinese children is associated with a variety of factors, among which a family history of asthma, a family history of allergy, atopic constitution, a history of allergies, allergic comorbidities, cesarean section, and bad family environment can increase the risk of asthma in children, while breastfeeding can reduce the risk.