摘要
目的分析儿童维生素D(Vitamin D,VD)与重症手足口病的相关性。方法计算机检索Pubmed、Cochrane Library、Web of science、Embase、中国期刊全文数据库(CNKI)、维普数据库、万方数据库和中国生物医学文献数据库(CBM),查找儿童VD与手足口病相关的临床研究,检索时限从建库到2022年9月。采用Revman5.4软件对纳入研究进行Meta分析。结果最终纳入12篇对照性研究(n=2090),按纽卡斯尔-渥太华量表(NOS)进行文献质量评价均≥6分。结果显示:手足口病重症组患儿VD水平低于轻症组(SMD=-0.74,95%CI:-0.99~-0.49,P<0.001),差异有统计学意义。亚组分析显示,VD不同检测方法的文献、是否控制目标混杂因素的文献以及不同研究类型的文献,重症组VD水平均低于轻症组。手足口病患儿中,VD缺乏者发生重症风险高于非缺乏者(OR=3.19,95%CI:1.59~6.41),且脑干脑炎(OR=6.85,95%CI:3.62~12.95)、神经源性肺水肿(OR=7.56,95%CI:3.74~15.29)、循环衰竭(OR=10.49,95%CI:4.70~23.43)发生风险均更高,具有统计学意义。纳入文献无明显发表偏倚,敏感性分析显示结果较为可靠。结论重症手足口病患儿VD水平较轻症低,VD缺乏是手足口病重症化的危险因素。监测VD水平对早期识别重症手足口病有一定参考意义。
Objective To analyze the correlation between vitamin D and severe hand-foot-mouth disease(HFMD)in children.Methods A systematic search was conducted through Pubmed,Cochrane Library,Web of Science,Embase,CNKI,CBM,VIP and Wanfang by computer from the establishment of the database to September,2022 for collecting clinical studies on the correlation between vitamin D and HFMD in children.Revman5.4 software were used for meta-analysis.Results Finally,12 controlled studies were included(n=2090).The literature quality was evaluated according to the Newcastle-Ottawa Scale(NOS),all articles were rated≥6 points.The results of Meta-analysis showed that the vitamin D level in the severe group was lower than that in the mild(SMD=-0.74,95%CI:-0.99~-0.49,P<0.001),the difference was statistically significant.Subgroup analysis showed that the vitamin D level of the severe group was lower than that of the mild,with statistically significant differences in the literatures of different detection methods,types of studies and whether target confounding factors were controlled.The risk of deterioration in HFMD children with vitamin D deficiency was higher(OR=3.19,95%CI:1.59-6.41),as brainstem encephalitis(OR=6.85,95%CI:3.62-12.95),neurogenic pulmonary edema(OR=7.56,95%CI:3.74-15.29)and circulatory failure(OR=10.49,95%CI:4.70-23.43),the difference was statistically significant.There was no significant publication bias in the included literature,and the sensitivity analysis showed that the results were reliable.Conclusions The vitamin D level of children with severe HFMD is lower than that of children with the mild.Vitamin D deficiency is a risk factor for symptoms worsen in HFMD.Monitoring vitamin D level has relative reference significance for early identification of severe HFMD.
作者
高一
张朝勇
段晓霞
龙璐
GAO Yi;ZHANG Chaoyong;DUAN Xiaoxia;LONG Lu(Public Health Clinical Center of Chengdu,Chengdu 610000,Sichuan Province,China;Department of Epidemiology and Health Statistics,West China Fourth Hospital and West China.School of Public Health,Sichuan University,Chengdu 610000,Sichuan Province,China)
出处
《预防医学情报杂志》
CAS
2023年第7期788-796,共9页
Journal of Preventive Medicine Information
基金
国家自然科学基金青年科学基金(项目编号:81903375)
中国博士后科学基金面上项目(项目编号:188309)
成都市科技局技术创新研发项目(项目编号:2019-YF05-01080-SN)。
