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支气管扩张症合并症如何影响哮喘患者?一项荟萃分析。

How does comorbid bronchiectasis affect asthmatic patients? A meta-analysis.

机构信息

Department of Pulmonary and Critical Care Medicine, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China.

出版信息

J Asthma. 2021 Oct;58(10):1314-1328. doi: 10.1080/02770903.2020.1784194. Epub 2020 Jul 7.

Abstract

OBJECTIVE

Asthma and bronchiectasis are known to be two distinct diseases with different etiology, pathophysiology, management, and prognosis. However, a high prevalence of bronchiectasis has been reported in patients with severe asthma. Thus, it is of great importance to identify the impact of bronchiectasis on asthmatic patients.

DATA SOURCES

Databases including PubMed, Embase, Cochrane, Web of Science were searched comprehensively to identify relevant human clinical studies published until February 2020.

STUDY SELECTIONS

Two investigators (Gelei Lan and Guochao Shi) independently obtained the potentially eligible articles based on their titles and abstracts. When opinions differed between the investigators, discussions were made to reach an agreement. The authors of the included studies were contacted for inquiry when necessary.

RESULTS

Six observational studies with 1004 patients were included in the meta-analysis. The mean prevalence of bronchiectasis in patients with asthma was 35.2% (ranging from 2.2% to 47%). Asthmatic patients with bronchiectasis were older, had a longer disease duration, exhibited greater severity, and showed more frequent exacerbations and hospitalization, and poorer lung function, compared with the patients without bronchiectasis.

CONCLUSION

Despite of the heterogeneity between included studies and detectable publication bias, this meta-analysis demonstrated the impact of comorbid bronchiectasis on asthmatic patients. Thus, coexistence of bronchiectasis should be considered a clinical phenotype of asthma, which may have associations with exacerbation and hospitalization.

摘要

目的

哮喘和支气管扩张症是两种不同的疾病,具有不同的病因、病理生理学、治疗和预后。然而,有研究报道严重哮喘患者中支气管扩张症的患病率较高。因此,明确支气管扩张症对哮喘患者的影响具有重要意义。

资料来源

全面检索了 PubMed、Embase、Cochrane、Web of Science 等数据库,以确定截至 2020 年 2 月发表的相关人类临床研究。

研究选择

两名研究者(Gelei Lan 和 Guochao Shi)根据标题和摘要独立获取潜在合格的文章。当意见存在分歧时,进行讨论以达成一致。必要时,与纳入研究的作者联系以进行询问。

结果

纳入的meta 分析共包含 6 项观察性研究,涉及 1004 名患者。哮喘患者中支气管扩张症的平均患病率为 35.2%(范围为 2.2%至 47%)。与无支气管扩张症的患者相比,合并支气管扩张症的哮喘患者年龄更大,疾病持续时间更长,病情更严重,发作和住院更频繁,肺功能更差。

结论

尽管纳入的研究之间存在异质性且存在可检测的发表偏倚,但这项 meta 分析表明合并支气管扩张症对哮喘患者的影响。因此,支气管扩张症的共存应被视为哮喘的一种临床表型,可能与加重和住院有关。

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