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糖尿病对急性肺损伤/急性呼吸窘迫综合征风险及死亡率的影响:一项荟萃分析。

The effect of diabetes on the risk and mortality of acute lung injury/acute respiratory distress syndrome: A meta-analysis.

作者信息

Ji Mingxia, Chen Mengyan, Hong Xiaofei, Chen Tiejiang, Zhang Ning

机构信息

Department of Emergency.

Department of Science and Education, Yiwu Central Hospital, Yiwu.

出版信息

Medicine (Baltimore). 2019 Mar;98(13):e15095. doi: 10.1097/MD.0000000000015095.

Abstract

BACKGROUND

The role of pre-existing diabetes in acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is still controversial. This systematic review and meta-analysis of observational studies aimed to evaluate the effect of diabetes on the risk and mortality of ALI/ARDS.

METHODS

A comprehensive literature search was performed in PubMed, Scopus, Cochrane Central Register of Controlled Trails and Web of Science for their inception to September 2018. Summary risk estimates were calculated with a DerSimonian and Laird random-effects model. Heterogeneity was evaluated using Cochran chi-square test and the I statistic.

RESULTS

Ultimately, 14 studies with a total of 6613 ALI/ARDS cases were included. The risk of ALI/ARDS was not significantly reduced in diabetes patients (OR 0.82, 95% CI 0.57-1.18, P = .283), with obvious heterogeneity across studies (I = 72.5%, P < .001). Further analyses in the meta-analysis also showed no statistically significant associations between pre-existing diabetes and in-hospital mortality (OR 0.79, 95% CI 0.51-1.21, P = .282) or 60-day mortality of ALI/ARDS (OR 0.91, 95% CI 0.75-1.11, P = .352).

CONCLUSION

This systematic review and meta-analysis of observational studies indicates that pre-existing diabetes have no effect on the risk and mortality of ALI/ARDS.

摘要

背景

既往糖尿病在急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)中的作用仍存在争议。这项对观察性研究的系统评价和荟萃分析旨在评估糖尿病对ALI/ARDS风险和死亡率的影响。

方法

在PubMed、Scopus、Cochrane对照试验中央注册库和Web of Science中进行了全面的文献检索,检索时间从各数据库建库至2018年9月。采用DerSimonian和Laird随机效应模型计算汇总风险估计值。使用Cochran卡方检验和I统计量评估异质性。

结果

最终纳入了14项研究,共6613例ALI/ARDS病例。糖尿病患者发生ALI/ARDS的风险未显著降低(OR=0.82,95%CI为0.57-1.18,P=0.283),各研究间存在明显异质性(I=72.5%,P<0.001)。荟萃分析中的进一步分析还显示,既往糖尿病与住院死亡率(OR=0.79,95%CI为0.51-1.21,P=0.282)或ALI/ARDS的60天死亡率(OR=0.91,95%CI为0.75-1.11,P=0.352)之间无统计学显著关联。

结论

这项对观察性研究的系统评价和荟萃分析表明,既往糖尿病对ALI/ARDS的风险和死亡率没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a842/6456090/3f669a91a62d/medi-98-e15095-g001.jpg

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