我国成人患者抗生素相关性腹泻危险因素的Meta分析
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篇名: 我国成人患者抗生素相关性腹泻危险因素的Meta分析
TITLE:
摘要: 目的:系统评价我国成人患者抗生素相关性腹泻(AAD)的危险因素,为临床提供循证参考。方法:计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase等数据库,收集我国成人患者AAD危险因素的病例对照研究,检索时限为2000年1月-2018年1月。提取资料并按照纽卡斯尔-渥太华质量评估量表对纳入文献进行质量评价后,采用Rev Man 5.2软件进行Meta分析。结果:共纳入14篇文献,共计20 914例患者。Meta分析结果显示,年龄≥65岁[OR=2.36,95%CI(1.99,2.79),P<0.001]、禁食[OR=4.65,95%CI(3.79,5.69),P<0.001]、使用抑酸剂[OR=5.82,95%CI(3.77,8.98),P<0.001]、血清白蛋白水平≤30 g/L[OR=2.40,95%CI(2.00,2.88),P<0.001]、侵袭性操作[OR=3.95,95%CI(3.03,5.15),P<0.001]、入住ICU[OR=2.93,95%CI(2.38,3.60),P<0.001]、住院天数≥10 d[OR=4.08,95%CI(3.31,5.03),P<0.001]、使用抗生素种类≥3种[OR=1.98,95%CI(1.56,2.51),P<0.001]和抗生素用药时间≥10 d[OR=6.16,95%CI(3.22,11.76),P<0.001]与ADD的发生有显著相关性。结论:年龄≥65岁、禁食、使用抑酸剂、血清白蛋白水平≤30 g/L、侵袭性操作、入住ICU、住院天数≥10 d、使用抗生素种类≥3种和抗生素用药时间≥10 d是我国成人患者发生AAD的危险因素。
ABSTRACT: OBJECTIVE: To evaluate the risk factors for antibiotic-associated diarrhea (AAD) in Chinese adult patients systematically, and to provide evidence-based reference in clinic. METHODS: Retrieved from CNKI,VIP, CBM, Wanfang database, PubMed and Embase, etc., disease control studies about AAD risk factors of Chinese adult patients were collected.The retrieval time limit ranged from Jan. 2000 to Jan. 2018. Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality evaluation of included literatures with NOS scale. RESULTS: A total of 14 literatures were included, involving 20 914 patients. The result of Meta-analysis showed that age ≥65 years [OR=2.36, 95%CI(1.99,2.79), P<0.001], fasting [OR=4.65, 95%CI(3.79,5.69), P<0.001], use of acid suppressant [OR=5.82, 95%CI(3.77,8.98), P<0.001], serum albumin ≤30 g/L [OR=2.40, 95%CI(2.00,2.88), P<0.001], invasive operation [OR=3.95, 95%CI(3.03,5.15), P<0.001], stay in ICU [OR=2.93, 95%CI(2.38,3.60), P<0.001], hospitalization time ≥10 d [OR=4.08, 95%CI(3.31,5.03), P<0.001], antibiotic species ≥3 kinds [OR=1.98, 95%CI(1.56,2.51), P<0.001] and duration of antibiotics use ≥10 d [OR=6.16, 95%CI(3.22,11.76), P<0.001] were significantly correlated with the occurrence of AAD. CONCLUSIONS: Age ≥65 years, fasting, use of acid suppressant, serum albumin ≤30 g/L, invasive operation, stay in ICU, time of hospitalization ≥10 d, antibiotic species ≥3 kinds and duration of antibiotics use ≥10 d are risk factors for AAD in Chinese adult patients.
期刊: 2018年第29卷第20期
作者: 毛婷,李吉莹,王胜红,钟建明,李晓兰
AUTHORS: MAO Ting,LI Jiying,WANG Shenghong,ZHONG Jianming,LI Xiaolan
关键字: 抗生素相关性腹泻;成人患者;危险因素;Meta分析
KEYWORDS: Antibiotic-associated diarrhea; Adult patients; Risk factor; Meta-analysis
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