背景:急性呼吸道感染是哮喘急性发作的主要诱因。这项研究试图估计病毒的总体比例,非典型病原体,以及在哮喘加重的成年人中检测到的细菌。
方法:PubMed,EMBASE,从开始到2020年2月13日,搜索了CochraneLibrary数据库以及来自评论和参考文献的所有相关研究。两名作者独立进行研究选择,数据提取,以及质量评估。随后,荟萃分析,研究之间的异质性,在RStudio上进行发表偏倚评估.
结果:纳入了包含3511名成年人的43项符合条件的研究,其中21篇出版物提到急性哮喘发作期间的多种感染。Meta分析显示急性感染率为40.19%(95%置信区间[CI]34.53%-45.99%)。病毒,非典型病原体,细菌检出率为38.76%(95%CI32.02%-45.71%),8.29%(95%CI2.64%-16.27%),和7.05%(95%CI3.34%-11.81%)的哮喘患者在加重期,分别。鼻病毒感染始终是急性加重的主要诱因,比例为20.02%(95%CI14.84%-25.73%)。研究间的实质性异质性(CochranQ检验:479.43,P<0.0001,I2=91.2%)由亚组分析解释,表明那一年,区域,人口,呼吸分泌,检测方法,病原体,研究质量均为影响因素。
结论:这项荟萃分析为成年人提供了第一批定量流行病学数据,在未来,在这方面需要更多的研究和医疗保健支持。
BACKGROUND: Acute respiratory infections are a major trigger of asthma exacerbations. This study sought to estimate the overall proportion of viruses, atypical pathogens, and bacteria detected in adults with asthma exacerbations.
METHODS: PubMed, EMBASE, and Cochrane Library databases and all related studies from the reviews and references were searched from inception to February 13, 2020. Two authors independently performed study selection, data extraction, as well as quality evaluation. Subsequently, meta-analysis, between-study heterogeneity, and publication bias assessment were conducted on RStudio.
RESULTS: Forty-three eligible studies comprising 3511 adults were included, of which 21 publications mentioned multiple infections during acute asthma attacks. Meta-analysis showed an acute infection prevalence of 40.19% (95% confidence interval [CI] 34.53%-45.99%). Viruses, atypical pathogens, and bacteria were detected in 38.76% (95% CI 32.02%-45.71%), 8.29% (95% CI 2.64%-16.27%), and 7.05% (95% CI 3.34%-11.81%) of asthmatics during exacerbations, respectively. Rhinovirus infections are always the dominant trigger for exacerbations with a proportion of 20.02% (95% CI 14.84%-25.73%). Substantial heterogeneity across studies (Cochran Q test: 479.43, P < 0.0001, I2 = 91.2%) was explained by subgroup analysis, indicating that year, region, population, respiratory secretion, detection method, pathogen, and study quality were all influencing factors.
CONCLUSIONS: This meta-analysis provided the first quantitative epidemiological data for adults, and in the future, more research and health-care supports are necessary in this area.