戒烟对慢性阻塞性肺疾病患者的影响：一项系统评价和荟萃分析。
Effects of smoking cessation on individuals with COPD: a systematic review and meta-analysis.
作者信息
Wang Zihan, Qiu Yifan, Ji Xiang, Dong Liang
机构信息
Department of Respiratory, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Respiratory and Critical Care Medicine, Research Center for Chronic Airway Diseases, Peking University Health Science Center, Peking University Third Hospital, Beijing, China.
出版信息
Front Public Health. 2024 Dec 11;12:1433269. doi: 10.3389/fpubh.2024.1433269. eCollection 2024.
OBJECTIVE
Despite smoking being a significant risk factor in the occurrence and progression of chronic obstructive pulmonary disease (COPD), no comprehensive analysis has been conducted to determine the potential benefits of smoking cessation for patients with established COPD or identify specific indicators that may be improved. The aim of our meta-analysis was to elucidate the positive impact of smoking cessation on COPD.
METHODS
We conducted a comprehensive search of PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, Wan Fang and VIP databases to identify studies that met our eligibility criteria from inception up to 1, May 2024. Data were extracted independently by two authors and pooled using a random-effects model. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS).
RESULTS
Preliminary screening of publications gave a total of 13,460 documents after which the repetitive and non-compliant studies were removed. Eventually, 11 studies were included for follow-up analysis. The pooled results showed that cessation of smoking produced significant improvements in forced expiratory volume in one second (FEV1)% predicted (MD = 6.72, 95% CI, 4.55-8.89, < 0.001; I = 53%), FEV1/forced vital capacity (FVC) (MD = 6.82, 95% CI, 5.09-8.54, < 0.001; I = 0%), modified Medical Research Council (mMRC) (MD = -0.49, 95% CI, -0.95--0.02, = 0.040; I = 73%), 6-minute walk test (6-MWT) (MD = 64.46, 95% CI 14.60-114.32, = 0.010; I = 94%), partial oxygen pressure (MD = 1.96, 95% CI, 1.03-2.89, < 0.001; I = 0%), mortality (RR = 0.75, 95% CI, 0.56-1.00, = 0.05; I = 44%).
CONCLUSION
Our meta-analysis presented suggestive evidence that smoking cessation offered significant benefits to COPD patients, notably in the improvement of specific key indicators of pulmonary function (FEV1% predicted, FEV1/FVC), alleviating symptoms, enhancing exercise tolerance, and could reduce mortality.
PROSPERO REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier: CRD42022384123.
目的
尽管吸烟是慢性阻塞性肺疾病（COPD）发生和进展的重要危险因素，但尚未进行全面分析以确定戒烟对已确诊COPD患者的潜在益处，或确定可能得到改善的具体指标。我们的荟萃分析旨在阐明戒烟对COPD的积极影响。
方法
我们对PubMed、EMBASE、Web of Science、Cochrane图书馆、中国知网、万方和维普数据库进行了全面检索，以确定从数据库建立至2024年5月1日符合我们纳入标准的研究。由两名作者独立提取数据，并使用随机效应模型进行汇总。使用纽卡斯尔-渥太华量表（NOS）评估研究质量。
结果
对出版物进行初步筛选后共获得13460篇文献，之后剔除了重复和不符合要求的研究。最终，纳入11项研究进行后续分析。汇总结果显示，戒烟使预测的一秒用力呼气容积（FEV1）%有显著改善（MD = 6.72，95%CI，4.55 - 8.89，P < 0.001；I² = 53%），FEV1/用力肺活量（FVC）（MD = 6.82，95%CI，5.09 - 8.54，P < 0.001；I² = 0%），改良医学研究委员会（mMRC）评分（MD = -0.49，95%CI，-0.95 - -0.02，P = 0.040；I² = 73%），6分钟步行试验（6-MWT）（MD = 64.46，95%CI 14.60 - 114.32，P = 0.010；I² = 94%），血氧分压（MD = 1.96，95%CI，1.03 - 2.89，P < 0.001；I² = 0%），死亡率（RR = 0.75，95%CI，0.56 - 1.00，P = 0.05；I² = 44%）。
结论
我们的荟萃分析提供了提示性证据，表明戒烟对COPD患者有显著益处，尤其是在改善肺功能的特定关键指标（预测的FEV1%、FEV1/FVC）、缓解症状、提高运动耐力方面，并且可能降低死亡率。
PROSPERO注册：https://www.crd.york.ac.uk/prospero/，标识符：CRD42022384123 。
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