本文關(guān)鍵詞： 可吸入顆粒物 兒童 哮喘 系統(tǒng)評價(jià) Meta分析　出處：《重慶醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的定量分析大氣可吸入性顆粒物(PM2.5,PM10)暴露對兒童哮喘發(fā)病風(fēng)險(xiǎn)的影響。方法計(jì)算機(jī)檢索PubMed、EMBASE、Cochrane圖書館、Ovid、中國生物醫(yī)學(xué)數(shù)據(jù)庫、中國知網(wǎng)和萬方數(shù)據(jù)庫,檢索時(shí)間均為建庫至2014年11月,同時(shí)手工檢索相關(guān)雜志,納入可吸入顆粒物暴露與兒童哮喘關(guān)聯(lián)的觀察性研究文獻(xiàn)。采用NOS和AHRQ量表進(jìn)行文獻(xiàn)偏倚評價(jià)。以可吸入性顆粒物每升高10 ug.m-3與兒童哮喘發(fā)病風(fēng)險(xiǎn)關(guān)聯(lián)強(qiáng)度的OR及其95%CI作為效應(yīng)量,按急性效應(yīng)和慢性效應(yīng)分別行Meta分析,進(jìn)一步按PM2.5和PM10行亞組分析。采用Revman5.3和Stata12.0軟件分別行異質(zhì)性分析及發(fā)表偏倚檢驗(yàn),根據(jù)異質(zhì)性分析結(jié)果采用相應(yīng)的效應(yīng)模型合并效應(yīng)值。結(jié)果31篇文獻(xiàn)進(jìn)入Meta分析,隊(duì)列研究10篇,橫斷面研究12篇,病例交叉研究8篇,時(shí)間序列研究2篇。(1)22篇文獻(xiàn)報(bào)道了可吸入性顆粒對兒童哮喘發(fā)病風(fēng)險(xiǎn)的慢性效應(yīng),文獻(xiàn)間具異質(zhì)性(P≤0.1,I2=72%),隨機(jī)效應(yīng)模型的Meta分析結(jié)果顯示,合并OR=1.10(95%CI:1.03~1.17),即大氣PM2.5或PM10濃度每上升10 ug.m-3,兒童哮喘的發(fā)病風(fēng)險(xiǎn)升高10%;亞組分析顯示,PM2.5和PM10合并的OR值分別為1.08(95%CI:1.02~1.15)和1.10(95%CI:1.01~1.20)。(2)9篇文獻(xiàn)報(bào)道了可吸入性顆粒對兒童哮喘發(fā)病風(fēng)險(xiǎn)的急性效應(yīng),文獻(xiàn)間具異質(zhì)性(P≤0.1,I2=63%),隨機(jī)效應(yīng)模型的Meta分析結(jié)果顯示,合并OR=1.05(95%CI:1.02-1.08),即大氣PM2.5或PM10濃度每上升10ug.m-3,兒童哮喘的發(fā)病風(fēng)險(xiǎn)升高5%;亞組分析顯示,PM2.5和PM10合并的OR值分別為1.06(95%CI:1.02~1.10)和1.05(95%CI:1.02~1.08)。(3)Egger直線回歸法發(fā)表偏倚檢驗(yàn)顯示,急性效應(yīng)不存在明顯發(fā)表偏倚,慢性效應(yīng)存在明顯發(fā)表偏倚。結(jié)論P(yáng)M2.5和PM10水平與兒童哮喘發(fā)病風(fēng)險(xiǎn)的急性和慢性效應(yīng)存在顯著關(guān)聯(lián)。
[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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