耐多药结核病发病危险因素的Meta分析

摘要

Objective To synthetically evaluate the risk factors of multidrug resistant tuberculosis (MDR-TB) in China.Methods Chinese databases (CNKI,Wanfang,SinoMed and VIP) and English database(PubMed) were used to collect studies on risk factors for MDR-TB from 1990 to 2013.Meanwhile,relevant studies were manually retrieved.According to the inclusion and exclusion criteria,studies were screened,data were extracted and quality assessed.A Meta-analysis was performed by using Stata 11.0 software.Results Twenty five studies on the risk factors of MDR-TB were synthetically and quantitatively analyzed.The results of Meta-analysis showed that factors as:being Han ethnic group,history of tuberculosis treatment,pulmonary cavity,floating population,TB case contact history,regular medication,living in rural areas,and poor economy were associated with the incidence of MDR-TB,the pooled OR values were 3.12 (95％CI:1.16-8.40),5.27 (95％ CI:3.60-7.72),1.39 (95％ CI:1.03-1.87),1.69 (95％ CI:1.07-2.68),4.34 (95％ CI:1.91-9.86),0.23 (95％ CI:0.16-0.35),1.86 (95％CI:1.59-2.18) and 1.62 (95％ CI:1.34-1.96),respectively.Conclusion Factors as:being Han ethnic group,history of tuberculosis treatment,pulmonary cavity,floating population,TB case contact history,living in rural areas and poor economy were considered to be at risk of MDR-TB while regular medication might be a protective factor to MDR-TB.%目的 系统评价中国居民耐多药结核病(MDR-TB)发生的主要危险因素.方法 计算机检索英文数据库PubMed及中文数据库中国知网(CNKI)、万方数据知识服务平台(Wan fang)、中国生物医学文献服务系统(SinoMed)与维普期刊资源整合服务平台(VIP)中1990-2013年与MDR-TB发病危险因素有关的研究,同时手工检索相关资料.严格按照纳入和排除标准对所获文献进行筛选、提取资料和质量评价,之后应用Stata 11.0软件进行Meta分析.结果 最终纳入文献共25篇.Meta分析显示,汉族、结核病治疗史、肺部空洞、流动人口、结核病患者接触史、规律服药、居住在农村和家庭经济状况差与MDR-TB发病相关,各因素分析合并OR值及其95％CI值分别为3.12(1.16 ～ 8.40)、5.27(3.60～7.72)、1.39(1.03～1.87)、1.69(1.07～2.68)、4.34(1.91 ～9.86)、0.23(0.16～0.35)、1.86(1.59～2.18)和1.62(1.34～ 1.96).结论 汉族、结核治疗史、肺部空洞、流动人口、结核接触史、居住在农村、家庭经济状况差是MDR-TB发病的危险因素,规律服药是其保护因素.