摘要
目的系统评价慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者死亡危险因素。方法检索PubMed、Cochrane Library、Web of Science、Embase、中国知网、维普网、万方数据知识服务平台和中国生物医学文献数据库有关COPD患者死亡危险因素的研究,再筛选文献、提取数据和质量评价,并进行荟萃分析。结果纳入15篇队列研究,纽卡斯尔-渥太华(Newcastle-Ottawa Scale,NOS)量表评分7~9分。荟萃分析结果显示:高龄(HR=1.074,95%CI:1.048~1.101,P<0.001)、吸烟(HR=1.390,95%CI:1.298~1.490,P<0.001)、低BMI(HR=1.434,95%CI:1.190~1.727,P<0.001)、高改良英国医学研究学会呼吸困难指数(modified British medical research council,mMRC)(HR=1.597,95%CI:1.550~1.646,P<0.001)、高Charlson共病指数(Charlson comorbidity index,CCI)(HR=1.191,95%CI:1.096~1.294,P<0.001)、Ⅳ级COPD(HR=2.114,95%CI:1.681~2.658,P<0.001)与COPD患者死亡关联有统计学意义。女性(HR=1.091,95%CI:0.781~1.522,P=0.610)、低去脂体重指数(fat free mass index,FFMI)(HR=3.025,95%CI:0.268~34.203,P=0.371)与COPD患者死亡关联无统计学意义。描述性分析结果显示高N端脑钠肽前体(N-terminal pro-brain nitric peptide,NT-proBNP)、铜绿假单孢菌(pseudomonas aeruginosa,PA)阳性可能是COPD患者死亡的危险因素。结论高龄、吸烟、低BMI、高mMRC、高CCI、Ⅳ级COPD是COPD患者死亡的独立危险因素,女性和低FFMI不是COPD患者死亡的危险因素,高NT-proBNP、PA感染与COPD患者的死亡关系还需进一步研究证明。
Objective To systematically review the risk factors for death in chronic obstructive pulmonary disease(COPD)patients.Methods PubMed,Cochrane Library,Web of Science,Embase,CNKI,CBM,VIP and WanFang databases were searched to query the original studies.Then two researchers further screened the studies simultaneously,extracted the data and assessed study quality,and performed Meta-analysis.Results A total of 15 studies were included with Newcastle-Ottawa Scale(NOS)score were among 7 to 9.Meta-analysis showed that elderly people(HR=1.074,95%CI:1.048-1.101,P<0.001),had a high Charlson comorbidity index(CCI)score(HR=1.191,95%CI:1.096-1.294,P<0.001),low BMI(HR=1.434,95%CI:1.190-1.727,P<0.001),smoking(HR=1.390,95%CI:1.298-1.490,P<0.001),had a high modified British medical research council(mMRC)score(HR=1.597,95%CI:1.550-1.646,P<0.001),hadⅣCOPD(HR=2.114,95%CI:1.681-2.658,P<0.001)were related to the mortality in COPD patients.There was no statistically significant difference between women(HR=1.091,95%CI:0.781-1.522,P=0.610),low fat free mass index(FFMI)(HR=3.025,95%CI:0.268-34.203,P=0.371)and COPD mortality.Descriptive analysis results showed that high N-terminal pro-brain nitric peptide(NT-proBNP),positive pseudomonas aeruginosa(PA)might be involved in the deaths of COPD patients.Conclusions Among COPD patients,those with advanced age,low BMI,had high CCI and mMRC index score,smoking and those withⅣCOPO were more likly to have mortality outcomes.And the relationship between high NT-proBNP,PA infection and the mortality in COPD patients still needed further research.
作者
朱琳
高静
柏丁兮
吴晨曦
游倩
ZHU Lin;GAO Jing;BAI Ding-xi;WU Chen-xi;YOU Qian(Department of Internal Medicine and Pediatrics,School of Nursing,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China)
出处
《中华疾病控制杂志》
CAS
CSCD
北大核心
2022年第4期455-462,共8页
Chinese Journal of Disease Control & Prevention
基金
成都市科学技术厅(2015-HM01-00469-SF)。
关键词
慢性阻塞性肺疾病
死亡
危险因素
队列研究
系统综述
Chronic obstructive pulmonary disease
Death
Risk factors
Cohort studies
Systematic review
