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特应性皮炎的非过敏性共病:系统评价概述。

Nonallergic comorbidities of atopic eczema: an overview of systematic reviews.

机构信息

Centre for Evidence-Based Healthcare, University Hospital Dresden, Dresden, Germany.

出版信息

Allergy. 2014 Jan;69(1):37-45. doi: 10.1111/all.12246. Epub 2013 Sep 21.

Abstract

The aims of this overview are to synthesize the current evidence of published systematic reviews (SRs) on nonallergic comorbidities of atopic eczema (AE). EMBASE and MEDLINE were searched for SRs published from inception to November 2012. SRs were selected independently based on predefined inclusion criteria. Methodological quality of SRs included was assessed by two independent reviewers using the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) checklist. Nine SRs met all inclusion criteria. Six reviews addressing the association between AE and cancer suggest a decreased risk of glioma, meningioma, and acute lymphoblastic leukemia in patients with current or previous AE. One SR reported a consistent positive association of AE with attention-deficit hyperactivity disorder (ADHD). Diabetes mellitus type 1 and multiple sclerosis (MS) were not significantly related to AE in reviews based on cross-sectional and case-control studies. Patients with AE appear to be at decreased risk of brain tumors. The relationship of AE with Th1- and Th17-mediated (auto-)inflammatory conditions such as diabetes mellitus type 1 and MS should be clarified in prospective observational studies. Children with AE are at increased risk of ADHD. SRs on the risk of depression and Th17-mediated disorders such as inflammatory bowel disease of patients with AE are missing.

摘要

本综述的目的是综合目前已发表的特应性皮炎(AE)伴发非过敏性共病的系统评价(SR)的证据。检索了 EMBASE 和 MEDLINE 数据库中从建库至 2012 年 11 月发表的 SR。根据预先设定的纳入标准,独立地选择 SR。使用改良的多系统评价评估工具(R-AMSTAR)检查表评估纳入的 SR 的方法学质量。有 9 项 SR 符合所有纳入标准。6 项评估 AE 与癌症之间关联的综述表明,当前或既往 AE 患者罹患神经胶质瘤、脑膜瘤和急性淋巴细胞白血病的风险降低。有 1 项 SR 报告 AE 与注意力缺陷多动障碍(ADHD)之间存在一致的正相关。基于横断面和病例对照研究的综述表明,1 型糖尿病和多发性硬化症(MS)与 AE 无显著相关性。AE 患者似乎罹患脑肿瘤的风险降低。AE 与 Th1 和 Th17 介导的(自身)炎症性疾病(如 1 型糖尿病和 MS)之间的关系应在前瞻性观察性研究中阐明。AE 患儿罹患 ADHD 的风险增加。AE 患者罹患抑郁症和 Th17 介导疾病(如炎症性肠病)的风险的 SR 尚缺乏。

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