肺结核患者并发肺部真菌感染危险因素的meta分析

doi:10.3969/j.issn.1006-3110.2021.08.003

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摘要目的系统评价肺结核患者并发肺部真菌感染的主要危险因素。方法在线检索中国知网、维普、万方和PubMed数据库中从建库至2020年2月28日发表的与肺结核患者并发肺部真菌感染相关文献,两名研究者根据纳入排除标准独立筛选文献、提取数据和质量评价后,采用Stata 12.0软件进行统计分析。结果最终纳入文献16篇,meta分析结果显示:年龄≥60岁(OR=4.51,95%CI:1.85~10.96)、病程≥5年(OR=4.32,95%CI:3.04~6.14)、复治肺结核(OR=5.82,95%CI:3.08~11.00)、病变累及肺野数≥3个(OR=2.82,95%CI:2.33~3.42)、有肺部空洞(OR=3.44,95%CI:2.06~5.75)、合并糖尿病(OR=2.05,95%CI:1.75~2.42)、侵入性操作(OR=6.42,95%CI:4.54~9.08)、长期使用广谱抗生素(OR=4.52,95%CI:1.79~11.39)、长期使用糖皮质激素(OR=3.74,95%CI:2.26~6.19)、痰涂片阳性(OR=0.49,95%CI:0.28~0.87)与肺结核患者并发肺部真菌感染相关;性别与肺结核患者并发肺部真菌感染未见明显关联(P=0.066)。结论高龄、病程长、复治肺结核、病变累及肺野数多、有肺部空洞、合并糖尿病、侵入性操作、长期使用广谱抗生素、长期使用糖皮质激素是肺结核患者并发肺部真菌感染的主要危险因素。

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	黄国军
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	白丽琼

关键词 ：结核病, 肺, 真菌感染, meta分析, 危险因素

Abstract：Objective To systematically review the main risk factors of pulmonary fungal infection in patients with pulmonary tuberculosis. Methods Literatures about pulmonary fungal infection in patients with pulmonary tuberculosis were retrieved from CNKI, VIP, Wanfang and PubMed from their establishment to February 28, 2020. Two researchers independently screened theliteratures according to the inclusion and exclusion criteria, extracted the data and evaluated the quality. The meta-analysis was performed by Stata12.0. Results A total of 16 studies were included in the final analysis. The meta-analysis showed that patients aged 60 years and above (OR=4.51, 95%CI:1.85-10.96), duration of disease more than or equal to 5 years (OR=4.32, 95%CI:3.04-6.14), retreated pulmonary tuberculosis (OR=5.82, 95%CI: 3.08-11.00), number of lesion more than or equal to 3 pulmonary fields (OR=2.82, 95%CI: 2.33-3.42), having pulmonary cavity (OR=3.44, 95%CI: 2.06-5.75), complicated with diabetes (OR=2.05, 95%CI: 1.75-2.42), invasive procedures (OR=6.42, 95%CI: 4.54-9.08), long-term use of broad-spectrum antibiotics (OR=4.52, 95%CI:1.79-11.39), long-term use of glucocorticoids (OR=3.74, 95%CI:2.26-6.19) and sputum smear positive (OR=0.49, 95%CI: 0.28-0.87) were associated with the development of pulmonary fungal infection in patients with pulmonary tuberculosis, but there was no significant association between gender and the development of pulmonary fungal infection in patients with pulmonary tuberculosis (P=0.066). Conclusion The main risk factors of pulmonary fungal infection in patients with pulmonary tuberculosis are advanced age, long-term course of disease, retreated pulmonary tuberculosis, wide range of pulmonary lesion, having pulmonary cavity, complicated with diabetes, invasive procedures, long-term use of broad-spectrum antibiotics and long-term use of glucocorticoids.

Key words： tuberculosis pulmonary fungal infection meta-analysis risk factor

收稿日期: 2020-08-25

R521

基金资助:“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项(2018ZX10722301-004);湖南省科技创新平台与人才计划(2018SK7003)

通讯作者: 白丽琼,E-mail:liqiong99@126.com。

作者简介: 黄国军(1988-),男,硕士,主要从事结核病防控和研究工作。

引用本文:

黄国军, 高晓, 唐细良, 尹诗林, 白丽琼. 肺结核患者并发肺部真菌感染危险因素的meta分析[J]. 实用预防医学, 2021, 28(8): 906-910. HUANG Guo-jun, GAO Xiao, TANG Xi-liang, YIN Shi-lin, BAI Li-qiong. Risk factors of pulmonary fungal infection in patients with pulmonary tuberculosis: a meta-analysis. , 2021, 28(8): 906-910.

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