Abstract：
The prevalence of allergic bronchopulmonary aspergillosis (ABPA) in asthmatic patients remains unclear and is likely different across geographic locales.
To systematically review the literature for estimating the prevalence of Aspergillus sensitization (AS) and ABPA in adults with bronchial asthma.
We searched the PubMed and Embase databases for studies reporting the prevalence of AS or ABPA in at least 50 asthmatic subjects. The primary outcome was to assess the prevalence of ABPA. The secondary outcome was to evaluate the prevalence of AS in asthma and that of ABPA in asthma with AS. We pooled the prevalence estimates using a random-effects model and examined the factors influencing the prevalence using multivariate meta-regression.
Of the 11,801 records retrieved, 86 studies with 25,770 asthmatic subjects met the inclusion criteria. Most of the studies were from tertiary care centers. The pooled prevalence of ABPA in asthma (47 studies; 9822 asthmatic subjects) was 11.3% (95% CI, 8.7-14.2). The pooled prevalence of AS in asthma (73 studies; 23,003 asthmatic subjects) was 25.1% (95% CI, 20.5-30.0), whereas the prevalence of ABPA in AS (36 studies; 2954 asthmatic subjects) was 37.0% (95% CI, 27.9-46.6). Multivariate meta-regression identified studies published from India (odds ratio, 1.11; 95% CI, 1.01-1.23) as the only factor associated with higher ABPA prevalence. There was presence of significant statistical heterogeneity and publication bias.
We found a high prevalence of ABPA in adult asthmatic subjects, underscoring the need for screening for ABPA in all asthmatic subjects seeking tertiary care.
To systematically review the literature for estimating the prevalence of Aspergillus sensitization (AS) and ABPA in adults with bronchial asthma.
We searched the PubMed and Embase databases for studies reporting the prevalence of AS or ABPA in at least 50 asthmatic subjects. The primary outcome was to assess the prevalence of ABPA. The secondary outcome was to evaluate the prevalence of AS in asthma and that of ABPA in asthma with AS. We pooled the prevalence estimates using a random-effects model and examined the factors influencing the prevalence using multivariate meta-regression.
Of the 11,801 records retrieved, 86 studies with 25,770 asthmatic subjects met the inclusion criteria. Most of the studies were from tertiary care centers. The pooled prevalence of ABPA in asthma (47 studies; 9822 asthmatic subjects) was 11.3% (95% CI, 8.7-14.2). The pooled prevalence of AS in asthma (73 studies; 23,003 asthmatic subjects) was 25.1% (95% CI, 20.5-30.0), whereas the prevalence of ABPA in AS (36 studies; 2954 asthmatic subjects) was 37.0% (95% CI, 27.9-46.6). Multivariate meta-regression identified studies published from India (odds ratio, 1.11; 95% CI, 1.01-1.23) as the only factor associated with higher ABPA prevalence. There was presence of significant statistical heterogeneity and publication bias.
We found a high prevalence of ABPA in adult asthmatic subjects, underscoring the need for screening for ABPA in all asthmatic subjects seeking tertiary care.
摘要：
背景：哮喘患者中过敏性支气管肺曲霉病（ABPA）的患病率尚不清楚，可能因地域而异。
目的：系统回顾评估成人支气管哮喘曲霉菌致敏（AS）和ABPA患病率的文献。
方法：我们在PubMed和Embase数据库中搜索了至少50名哮喘患者中AS或ABPA患病率的研究。主要结果是评估ABPA的患病率。次要结果是评估哮喘中AS和哮喘合并AS中ABPA的患病率。我们使用随机效应模型汇总了患病率估计值，并使用多变量meta回归检查了影响患病率的因素。
结果：在检索到的11,801条记录中，有25,770名哮喘受试者的86项研究符合纳入标准。大多数研究来自高等教育中心。哮喘（47项研究；9822例哮喘患者）中ABPA的合并患病率为11.3％（95％置信区间[CI]，8.7-14.2)。哮喘中AS的合并患病率（73项研究；23,003例哮喘患者）为25.1％（95％CI，20.5-30.0），而ABPA在AS中的患病率（36项研究;2954例哮喘患者）为37.0％（95％CI，27.9-46.6）。多变量meta回归将印度发表的研究（OR1.11;95％CI，1.01-1.23）确定为与较高ABPA患病率相关的唯一因素。存在显著的统计异质性和发表偏倚。
结论：我们发现成人哮喘患者中ABPA的患病率很高，强调需要筛查所有接受ABPA三级治疗的哮喘受试者。
目的：系统回顾评估成人支气管哮喘曲霉菌致敏（AS）和ABPA患病率的文献。
方法：我们在PubMed和Embase数据库中搜索了至少50名哮喘患者中AS或ABPA患病率的研究。主要结果是评估ABPA的患病率。次要结果是评估哮喘中AS和哮喘合并AS中ABPA的患病率。我们使用随机效应模型汇总了患病率估计值，并使用多变量meta回归检查了影响患病率的因素。
结果：在检索到的11,801条记录中，有25,770名哮喘受试者的86项研究符合纳入标准。大多数研究来自高等教育中心。哮喘（47项研究；9822例哮喘患者）中ABPA的合并患病率为11.3％（95％置信区间[CI]，8.7-14.2)。哮喘中AS的合并患病率（73项研究；23,003例哮喘患者）为25.1％（95％CI，20.5-30.0），而ABPA在AS中的患病率（36项研究;2954例哮喘患者）为37.0％（95％CI，27.9-46.6）。多变量meta回归将印度发表的研究（OR1.11;95％CI，1.01-1.23）确定为与较高ABPA患病率相关的唯一因素。存在显著的统计异质性和发表偏倚。
结论：我们发现成人哮喘患者中ABPA的患病率很高，强调需要筛查所有接受ABPA三级治疗的哮喘受试者。
