Yao Mei-Mei, Gao Tian-Ji, Zhao Min, Fu Yan-Hua, Liu Jing, Wang Tian-Jiao, Yang Ying
Department of Rheumatology and Immunology, Baoding Hospital, Beijing Children's Hospital Affiliated to Capital Medical University, Baoding, China.
Front Pediatr. 2024 Aug 1;12:1361850. doi: 10.3389/fped.2024.1361850. eCollection 2024.
To preliminarily explore the risk factors for post-infectious bronchiolitis obliterans (PIBO) complicating adenovirus pneumonia (ADVP) in children through a meta-analysis.
A systematic search was conducted on three English-language databases (PubMed, Web of Science and The National Library of Medicine) and two Chinese-language databases (China National Knowledge Infrastructure and the Wanfang Database) between database inception and 1 January 2023. Data analysis was conducted using Stata 15.1 software.
A total of 10 articles, reporting 14 risk factors, were included in the analysis, with 8 risk factors taken into consideration. Through the meta-analysis, 5 risk factors were identified for PIBO complicating ADVP in paediatric patients: hypoxaemia [odds ratio (OR) = 9.37, 95% CI: 4.22, 20.77, < 0.001], persistent wheezing (OR = 4.65, 95% CI: 2.20, 9.82, < 0.001), mechanical ventilation (OR = 3.87, 95% CI: 2.37, 6.33, < 0.001), length of hospital stay (LoHS) (OR = 1.25, 95% CI: 1.09, 1.43, < 0.001) and fever duration (OR = 1.08, 95% CI: 1.02, 1.14, 0.009).
Existing evidence suggests that hypoxaemia, persistent wheezing, mechanical ventilation, LoHS and fever duration are risk factors for PIBO complicating ADVP in children. These findings underscore the need for enhanced assessment and management in clinical practice. This study may provide such a clinical prediction model from the identified 5 risk factors for PIBO and offer valuable insights for preventing bronchiolitis obliterans in children with ADVP.
通过荟萃分析初步探讨儿童感染后闭塞性细支气管炎（PIBO）并发腺病毒肺炎（ADVP）的危险因素。
在数据库建立至2023年1月1日期间，对三个英文数据库（PubMed、Web of Science和美国国立医学图书馆）和两个中文数据库（中国知网和万方数据库）进行系统检索。使用Stata 15.1软件进行数据分析。
分析共纳入10篇报道14个危险因素的文章，考虑了8个危险因素。通过荟萃分析，确定了小儿患者PIBO并发ADVP的5个危险因素：低氧血症[比值比（OR）=9.37，95%置信区间（CI）：4.22，20.77，P<0.001]、持续性喘息（OR=4.65，95%CI：2.20，9.82，P<0.001）、机械通气（OR=3.87，95%CI：2.37，6.33，P<0.001）、住院时间（LoHS）（OR=1.25，95%CI：1.09，1.43，P<0.001）和发热持续时间（OR=1.08，95%CI：1.02，1.14，P=0.009）。
现有证据表明，低氧血症、持续性喘息、机械通气、LoHS和发热持续时间是儿童PIBO并发ADVP的危险因素。这些发现强调了临床实践中加强评估和管理的必要性。本研究可能从确定的PIBO的5个危险因素中提供这样一个临床预测模型，并为预防ADVP患儿的闭塞性细支气管炎提供有价值的见解。
