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儿童慢性咳嗽的危险因素:涵盖五大洲的荟萃分析。

The risk factors for chronic cough in children: A meta-analysis covering five continents.

机构信息

School of Clinical Medicine, Shandong Second Medical University, Weifang, 261000, Shandong, China.

Department of Pediatrics Respiratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong Provincial Clinical Research Center for Children's Health and Disease Office, Ji'nan, 250021, China.

出版信息

Respir Med. 2024 Oct;232:107752. doi: 10.1016/j.rmed.2024.107752. Epub 2024 Jul 31.

Abstract

BACKGROUND

This study aimed to explore the risk factors for chronic cough in children and provide a reference for prevention and healthcare measures.

METHODS

PubMed, Web of Science, Cochrane, and EMBASE were searched for observational studies published up to April 2024. Outcome included risk factors associated with chronic cough in children. Two investigators independently searched and screened the literature, evaluated the qualities and extracted baseline datas. Results were analyzed using random-effects models with odds ratios and their 95 % confidence intervals to address heterogeneity. Subgroup analyses, sensitivity analyses and assessment of publication bias were performed. Stata17 and GRADEwas used for the meta-analysis.

RESULTS

18 studies including 97,462 children were reviewed. Asthma(OR = 4.06, 95%CI: 2.37-6.96, P<0.01), NO(OR = 1.19, 95%CI: 1.01-1.39, P = 0.031), Home remodeling history (OR = 1.82,95 % CI: 1.61-2.05, P<0.01), Environment Tobacco Smoke(OR = 1.41, 95 % CI: 1.15-1.73, P = 0.001), Pet exposure (OR = 1.56, 95%CI: 1.25-1.95, P<0.01), Mould (OR = 1.64,95%CI: 1.45-1.85, P<0.01), Age<1 year(OR = 3.19, 95 % CI: 1.8-5.63, P<0.01) were reported as risk factors for chronic cough in children, these results were discussed qualitatively in the study.

CONCLUSION

Asthma, NO, Home remodeling history, Environment Tobacco Smoke(ETS), Pet exposure, Mould, and Age<1 year are risk factors for chronic coughing in children. Due to the few studies and insufficient evidence, other potential risk factors need to be robustly confirmed by subsequent large-sample and multicenter trials.

摘要

背景

本研究旨在探讨儿童慢性咳嗽的危险因素,为预防和保健措施提供参考。

方法

检索 PubMed、Web of Science、Cochrane 和 EMBASE 数据库,收集截至 2024 年 4 月发表的观察性研究。结局指标为儿童慢性咳嗽的相关危险因素。由 2 位研究者独立检索和筛选文献、评价质量并提取基线数据。采用随机效应模型计算比值比(OR)及其 95%置信区间(CI)来评估异质性,并进行亚组分析、敏感性分析和发表偏倚评估。采用 Stata17 和 GRADE 软件进行 Meta 分析。

结果

共纳入 18 项研究,包含 97462 名儿童。哮喘(OR=4.06,95%CI:2.37-6.96,P<0.01)、NO(OR=1.19,95%CI:1.01-1.39,P=0.031)、家庭装修史(OR=1.82,95%CI:1.61-2.05,P<0.01)、环境烟草烟雾(OR=1.41,95%CI:1.15-1.73,P=0.001)、宠物暴露(OR=1.56,95%CI:1.25-1.95,P<0.01)、霉菌(OR=1.64,95%CI:1.45-1.85,P<0.01)、年龄<1 岁(OR=3.19,95%CI:1.8-5.63,P<0.01)被报道为儿童慢性咳嗽的危险因素,这些结果在研究中进行了定性讨论。

结论

哮喘、NO、家庭装修史、环境烟草烟雾(ETS)、宠物暴露、霉菌和年龄<1 岁是儿童慢性咳嗽的危险因素。由于研究数量较少且证据不足,其他潜在的危险因素需要通过后续的大样本、多中心试验进行有力证实。

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