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室外空气污染与单滞后 0 天和滞后 1 天暴露模式下哮喘恶化风险的关系:系统评价和荟萃分析。

Outdoor air pollution and the risk of asthma exacerbations in single lag0 and lag1 exposure patterns: a systematic review and meta-analysis.

机构信息

Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China.

Department of Cardiology, Peking University First Hospital, Beijing, China.

出版信息

J Asthma. 2022 Nov;59(11):2322-2339. doi: 10.1080/02770903.2021.2008429. Epub 2021 Dec 14.

DOI:10.1080/02770903.2021.2008429
PMID:34809505
Abstract

To synthesize evidence regarding the relationship between outdoor air pollution and risk of asthma exacerbations in single lag0 and lag1 exposure patterns. We performed a systematic literature search using PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials, China National Knowledge Internet, Chinese BioMedical, and Wanfang databases. Articles published until August 1, 2020 and the reference lists of the relevant articles were reviewed. Two authors independently evaluated the eligible articles and performed structured extraction of the relevant information. Pooled relative risks (RRs) and 95% confidence intervals (CIs) of lag0 and lag1 exposure patterns were estimated using random-effect models. Eighty-four studies met the eligibility criteria and provided sufficient information for meta-analysis. Outdoor air pollutants were associated with increased risk of asthma exacerbations in both single lag0 and lag1 exposure patterns [lag0: RR (95% CI) (pollutants), 1.057(1.011, 1.103) (air quality index, AQI), 1.007 (1.005, 1.010) (particulate matter of diameter ≤ 2.5 μm, PM), 1.009 (1.005, 1.012) (particulate matter of diameter, PM), 1.010 (1.006, 1.014) (NO), 1.030 (1.011, 1.048) (CO), 1.005 (1.002, 1.009) (O); lag1:1.064(1.022, 1.106) (AQI), 1.005 (1.002, 1.008) (PM), 1.007 (1.004, 1.011) (PM), 1.008 (1.004, 1.012) (NO), 1.025 (1.007, 1.042) (CO), 1.010 (1.006, 1.013) (O)], except SO [lag0: RR (95% CI), 1.004 (1.000, 1.007); lag1: RR (95% CI), 1.003 (0.999, 1.006)]. Subgroup analyses revealed stronger effects in children and asthma exacerbations associated with other events (including symptoms, lung function changes, and medication use). Outdoor air pollution increases the asthma exacerbation risk in single lag0 and lag1 exposure patterns. PROSPERO, CRD42020204097. https://www.crd.york.ac.uk/.Supplemental data for this article is available online at https://doi.org/10.1080/02770903.2021.2008429 .

摘要

目的

综合评估户外空气污染与单时滞 0 天和 1 天暴露模式下哮喘恶化风险之间的关系。

方法

我们使用 PubMed、Embase、Cochrane 图书馆、Web of Science、ClinicalTrials、中国国家知识基础设施、中国生物医学文献数据库和万方数据库进行了系统文献检索。检索截至 2020 年 8 月 1 日的相关文献,并查阅了相关文章的参考文献列表。两名作者独立评估合格文献,并对相关信息进行了结构化提取。采用随机效应模型计算时滞 0 天和 1 天暴露模式下的汇总相对风险(RR)和 95%置信区间(CI)。

结果

84 项研究符合纳入标准,并提供了充分的荟萃分析信息。户外空气污染物与哮喘恶化的风险增加有关,无论在单时滞 0 天还是 1 天暴露模式下(时滞 0 天:RR(95%CI)(污染物),1.057(1.011,1.103)(空气质量指数,AQI),1.007(1.005,1.010)(直径≤2.5μm 的颗粒物,PM),1.009(1.005,1.012)(PM),1.010(1.006,1.014)(NO),1.030(1.011,1.048)(CO),1.005(1.002,1.009)(O);时滞 1 天:1.064(1.022,1.106)(AQI),1.005(1.002,1.008)(PM),1.007(1.004,1.011)(PM),1.008(1.004,1.012)(NO),1.025(1.007,1.042)(CO),1.010(1.006,1.013)(O)),但 SO 除外[时滞 0 天:RR(95%CI),1.004(1.000,1.007);时滞 1 天:RR(95%CI),1.003(0.999,1.006)]。亚组分析显示,儿童和与其他事件(包括症状、肺功能变化和药物使用)相关的哮喘恶化的影响更强。

结论

户外空气污染增加了单时滞 0 天和 1 天暴露模式下的哮喘恶化风险。PROSPERO,CRD42020204097. https://www.crd.york.ac.uk/。本文的补充数据可在 https://doi.org/10.1080/02770903.2021.2008429 上获取。

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