Revista clinica espanola最新文献_第9页

Gammapatía monoclonal transitoria: un estudio unicéntrico 暂时性单克隆性伽马病：单中心研究

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-05-01 DOI: 10.1016/j.rce.2025.502286

M.Á. Gómez, F.J. Hermida

Objectives

Some of the monoclonal gammopathy of uncertain significance are transient monoclonal gammopathies, characterized by the appearance of a small serum paraprotein followed by its disappearance after a variable period of time. The aim of the present study is to examine the transient monoclonal gammopathies in our health area by describing their characteristics, as well as the pathology they presented at the time of the development of the monoclonal gammopathy.

Methods

A retrospective study was undertaken, in which all serum protein electrophoresis patterns performed during a 6-month period (January-2024/June-2024) were reviewed. All these serum protein electrophoresis were processed in the clinical analysis service of the Clinical Universitary Hospital of Santiago de Compostela from primary and secondary care of the Sanitary Area of Santiago de Compostela and Barbanza. Only patients without hematologic pathology who presented a serum protein electrophoresis without monoclonal gammopathy and who had previously presented a serum protein electrophoresis with the presence of monoclonal gammopathy were selected.

Results

A total of 80 transient monoclonal gammopathies were identified, of which 68 had a monoclonal pattern (85%) and 12 had an oligoclonal pattern (15%). We found different diagnoses coinciding with the presence of transient monoclonal gammopathy, among which we can highlight: 35 cases (43.7%) were infectious processes, 20 cases (25%) were autoimmune diseases and 12 cases (15%) were transplant patients.

Conclusions

Clinicians should consider the likelihood of a transient paraprotein to avoid unnecessary investigations and invasive procedures, which are used in case of suspected malignancy or persistent monoclonality.

一些单克隆γ病的不确定意义是短暂的单克隆γ病，其特征是出现一个小的血清副蛋白，然后在一段可变的时间后消失。本研究的目的是通过描述其特征来检查我们卫生领域的短暂性单克隆伽玛病，以及它们在单克隆伽玛病发展时呈现的病理。方法回顾性分析6个月期间（2024年1月-2024年6月）的所有血清蛋白电泳图谱。所有这些血清蛋白电泳均在圣地亚哥德孔波斯特拉临床大学医院的临床分析服务部门进行处理，来自圣地亚哥德孔波斯特拉和巴尔班萨卫生区的初级和二级保健。仅选择无血液学病理且血清蛋白电泳无单克隆γ病和先前血清蛋白电泳存在单克隆γ病的患者。结果共检出80例短暂性单克隆γ病变，其中单克隆型68例（85%），寡克隆型12例（15%）。我们发现不同的诊断与短暂性单克隆伽玛病的存在相吻合，其中我们可以强调：35例（43.7%）为感染性疾病，20例（25%）为自身免疫性疾病，12例（15%）为移植患者。结论临床医生应考虑短暂性副蛋白的可能性，以避免不必要的检查和侵入性手术，这是在怀疑恶性肿瘤或持续单克隆的情况下使用的。

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引用次数: 0

Alta rentabilidad diagnóstica de la biopsia con aguja gruesa ecoguiada de adenopatías realizada en un servicio de medicina interna 在内科进行的超声引导腺病粗针头活检的高成本效益诊断

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-05-01 DOI: 10.1016/j.rce.2025.502282

C. Escorial-Moya , I. Lobo-Matas , E. Calderón-Sandubete , F.J. Medrano-Ortega , J.M. Varela-Aguilar , J. Delgado-Cuesta

Background

Core needle biopsy (CNB) is often the initial test for polyadenopathic syndrome and is usually performed by radiologists. The objectives of this study are to determine the diagnostic yield of ultrasound-guided CNB of lymph nodes performed by internists at a tertiary care hospital, the most frequent etiological diagnoses, and the safety of this technique.

Materials

Observational, descriptive study in which we included all patients over 17 years of age who had undergone ultrasound-guided CNB of lymphadenopathy by a member of the internal medicine service of the Virgen del Rocío University Hospital in Seville from 2021-2023.

Results

A total of 76 patients were included, 49 (64.5%) were male and the median age [IQR] was 64 [42-75] years. The most frequent location of lymphadenopathy was inguinal (38.2%). This test allowed a definitive diagnosis in 71 (93.4%) of the patients. Of the 5 in whom the diagnosis was not reached by the CNB, three required an open biopsy, one was diagnosed with Bartonella henselae by serology and in a fifth the diagnosis was not reached. The median delay for the BAG [IQR] was 1 [0-3] days. No patient had complications. The most frequent diagnosis was lymphoma in 31 (41.8%) patients.

Conclusions

Ultrasound-guided CNB performed by internists is a safe, feasible test with very little delay. These data support the extension of this practice to the rest of the internal medicine services.

核心穿刺活检（CNB）通常是多腺病综合征的初始检查，通常由放射科医生进行。本研究的目的是确定三级护理医院内科医生进行的超声引导淋巴结CNB的诊出率，最常见的病因诊断以及该技术的安全性。材料：一项观察性描述性研究，我们纳入了所有17岁以上的患者，这些患者在2021-2023年期间接受了由塞维利亚圣母大学Rocío大学医院内科服务成员进行的超声引导下淋巴结病变CNB。结果共纳入76例患者，其中男性49例（64.5%），中位年龄[IQR] 64岁[42-75]岁。腹股沟淋巴结病变最常见（38.2%）。该检查对71例（93.4%）患者作出明确诊断。在未通过CNB诊断的5人中，3人需要开放活检，1人通过血清学诊断为亨塞拉巴尔通体，1人未确诊。BAG [IQR]的中位延迟为1[0-3]天。没有患者出现并发症。最常见的诊断是淋巴瘤，31例（41.8%）。结论超声引导下内科医师行CNB是一种安全、可行、延迟小的检查方法。这些数据支持将这种做法扩展到其他内科服务。

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引用次数: 0

Evaluación de la enfermedad renal crónica en las personas españolas con diabetes: un estudio llevado a cabo en las consultas de medicina interna 西班牙糖尿病患者的慢性肾病评估：内科会诊研究

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-05-01 DOI: 10.1016/j.rce.2025.01.003

J. Ena , J. Carretero Gómez , M. Suárez Tembra , L. Lajara Villar , C. Fernández Peña , A. Rosales Castillo , N. Domínguez Pinilla , F.J. Carrasco Sánchez , A. Bustos Merlo , A. Rabassa Soler , en nombre del Grupo de Trabajo de Diabetes, Obesidad y Nutrición de la Sociedad Española de Medicina Interna

Aim

To determine the prevalence and characteristics of chronic kidney disease (CKD) in a cross-sectional population of people with type 2 diabetes treated at internal medicine clinics in Spain.

Methods

We collected data from 25 hospitals which recruited 354 people with type 2 diabetes in an observational study carried out in May, 2024. Information collected included demographic data, comorbidities, nutritional status, presence of sarcopenia and frailty, as well as laboratory data and therapy administered.

Results

We included a total of 314 subjects, of whom 185 (58.9%; 95% confidence interval: 53.4-64.3%) had CKD. Compared with people with no CKD, those with CKD were older (77.4 ± 9.7 vs. 65.9 ± 12.5 years; P<0.001), more often male gender (53.1 vs. 46.9%; P=0.021), with more prevalence of ischemic heart disease (22.4 vs. 10.9%; P=.006) and longer duration of diabetes disease (14.1 ± 8.6 vs. 10.0 ± 7.0 years; P<0.001). Malnutrition (37.3 vs. 25%; P=0.017), sarcopenia (24.6 vs. 11.2%; P=0.003), and frailty (74.3 vs. 59%; P=0.006) was more often associated in people with CKD compared with those with no CKD.

Conclusion

Internal medicine specialists treat a significant number of people with diabetes and CKD. These people are characteristically elderly, with high proportion of cardiovascular disease showing malnutrition, sarcopenia, and frailty, which could determine the target for metabolic control.

目的确定在西班牙内科诊所接受治疗的2型糖尿病患者中慢性肾脏疾病（CKD）的患病率和特征。方法我们收集了来自25家医院的数据，在2024年5月开展的一项观察性研究中招募了354名2型糖尿病患者。收集的信息包括人口统计数据、合并症、营养状况、肌肉减少症和虚弱的存在，以及实验室数据和给予的治疗。结果共纳入314例受试者，其中185例（58.9%）；95%可信区间：53.4-64.3%)患有CKD。与无CKD患者相比，CKD患者年龄较大(77.4±9.7岁vs 65.9±12.5岁；P<0.001)，男性更常见(53.1 vs. 46.9%；P=0.021)，缺血性心脏病患病率更高(22.4%比10.9%；P= 0.006)，糖尿病病程更长(14.1±8.6∶10.0±7.0年；术中,0.001)。营养不良(37.3% vs. 25%；P=0.017)，肌肉减少症(24.6% vs. 11.2%；P=0.003)和虚弱(74.3 vs 59%；P=0.006)在CKD患者中与无CKD患者相比更常相关。结论内科专家治疗了相当数量的糖尿病和慢性肾病患者。这些人的特点是老年人，心血管疾病的比例高，表现为营养不良、肌肉减少和虚弱，这可以确定代谢控制的目标。

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引用次数: 0

Indicaciones urgentes de aféresis terapéutica. Grupo Español de Aféresis (GEA). Segunda edición 2024 治疗性痛风的紧急适应症。西班牙Aferesis集团（GEA）。2024年第二版

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-05-01 DOI: 10.1016/j.rce.2025.502284

I.M. Parra Salinas , J.A. García Erce , Grupo Español de Aféresis (GEA)

The Spanish Apheresis Group (GEA) presents the second edition of the “Urgent Indications for Therapeutic Apheresis” document, updated 12 years after its initial publication. This revision addresses the need to standardize its application, given the variability observed across different centers and the lack of resources in some provinces. A critical review of the most recent scientific evidence was conducted, including the latest edition of the American Society of Apheresis (ASFA) guidelines and other evidence-based recommendations. Through a methodological review and expert consensus, the list of conditions in which therapeutic apheresis—whether plasma exchange, red blood cell exchange, or cytoreductive apheresis—should be considered an urgent treatment has been redefined. This update introduces new indications and clinical scenarios where apheresis can provide significant therapeutic benefits.

西班牙单采组织（GEA）发布了“治疗单采的紧急适应症”文件的第二版，在其首次出版12年后进行了更新。鉴于在不同中心观察到的差异和一些省份缺乏资源，这次修订解决了标准化其应用的需要。对最新的科学证据进行了批判性审查，包括最新版的美国采血学会（ASFA）指南和其他循证建议。通过方法学回顾和专家共识，治疗性分离——无论是血浆交换、红细胞交换还是细胞减原性分离——应被视为紧急治疗的条件清单已被重新定义。该更新介绍了新的适应症和临床情况，其中采血可以提供显着的治疗益处。

引用次数: 0

Rentabilidad de las biopsias de lesiones focales guiadas por ecografía en un servicio de medicina interna 内科超声引导局灶性损伤活检的成本效益

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-05-01 DOI: 10.1016/j.rce.2025.502285

L. Porcel , S. Alas , S. Bielsa , J.M. Porcel

Background

Ultrasound-guided biopsy (UGB) is a diagnostic procedure that is usually performed by radiologists; however, its use by internists has been poorly studied. This study evaluated the diagnostic yield, accuracy, and safety of UGB for focal lesions with a high suspicion of malignancy in an internal medicine department.

Method

We retrospectively analyzed 255 UGB in 248 patients between 2021 and 2024. Solid organ biopsies were performed to evaluate diagnostic yield, complications, and factors associated with success.

Results

The overall diagnostic yield was 84% with an accuracy of 83% for malignancy and 89% for benignity. The biopsies predominantly comprised of hepatic, pulmonary, and lymph node specimens. Major complications occurred infrequently (3%). Factors such as sample size and accumulated experience improved the results.

Conclusions

UGBs performed by internists for focal lesions suspected of malignancy are safe and effective. Its implementation can reduce diagnostic time and improve patient care.

超声引导活检（UGB）是一种通常由放射科医生执行的诊断程序；然而，内科医生对其使用的研究却很少。本研究评估了UGB对内科高度怀疑恶性肿瘤的局灶性病变的诊断率、准确性和安全性。方法回顾性分析2021 - 2024年间248例患者的255例UGB。进行实体器官活检以评估诊断率、并发症和与成功相关的因素。结果总诊断率为84%，其中恶性肿瘤的准确率为83%，良性肿瘤的准确率为89%。活检主要包括肝、肺和淋巴结标本。主要并发症很少发生（3%）。样本量和经验积累等因素改善了结果。结论内科医师对怀疑为恶性灶性病变的局灶性病变行subb检查安全有效。它的实施可以缩短诊断时间并改善患者护理。

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引用次数: 0

Gobierno clínico en medicina interna: el desafío de la duración de la estancia hospitalaria 内科临床管理：住院时间的挑战

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-04-01 DOI: 10.1016/j.rce.2024.12.001

L.S. Pinheiroa

Clinical governance highlights the relevance of the combination of «quality» and «safety» with «excellence» and «improvement». In hospitals, as highly complex organizations the principles and practices of clinical governance are key elements for success. Several angles would be pertinent in the application of clinical governance to the hospital context, and specifically to internal medicine. The length of stay of patients in hospital is frequently used as a quality indicator of clinical activity. Ideally the patient should remain in the hospital during the time in which he has benefit, minimizing inherent risks. With its centrality in the patient, clinical governance, interpreted in the light of the Seven Pillars Model can provide a comprehensive framework for addressing the management of length of stay. We should try to bring to the day-to-day of our organizations the aggregating vision of clinical governance, whose foundational values need to be reinforced and deepened.

临床治理强调了“质量”和“安全”与“卓越”和“改进”相结合的相关性。在医院，作为高度复杂的组织，临床治理的原则和实践是成功的关键因素。将临床治理应用于医院环境，特别是应用于内科，有几个角度是相关的。病人住院时间经常被用作临床活动的质量指标。理想情况下，患者应在其受益期间留在医院，以尽量减少固有风险。临床治理以患者为中心，根据七大支柱模型进行解释，可以为解决住院时间管理提供一个全面的框架。我们应该尝试将临床治理的综合愿景带入我们组织的日常工作，其基本价值需要得到加强和深化。

引用次数: 0

VERICIDuAT: Estudio en vida real de vericiguat en pacientes con insuficiencia cardíaca con fracción de eyección reducida VERICIDuAT: Vericiguat在射出率降低的心力衰竭患者中的实际研究

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-04-01 DOI: 10.1016/j.rce.2024.11.005

S. Russo Botero , M. Ripoll Martínez , L. Fácila Rubio , A. Lamilla Álvarez , V. Montagud Balaguer , D. García Escrivá , E. Chover Sierra , Á. Sánchez Montagud , J. Pérez Silvestre

Introduction and objectives

The aim of this study is to assess the safety in a real-world cohort of patients with heart failure with reduced ejection fraction (HFrEF).

Methods

Observational, retrospective and single-center study with patients on vericiguat treatment from the Cardiology and Internal Medicine outpatient clinic of the Consorcio Hospital General Universitario de Valencia during 2023 year and with minimum follow-up of 6 months.

Patients with HFpEF diagnosis and optimized treatment according to the ESC 2021 clinical practice guidelines were included, to whom treatment with vericiguat was started.

Results

We included 123 patients with a mean age of 78 years, mostly men (62%) and with NYHA II functional status (52%). 98 patients completed follow-up after a median follow-up of 162 days (IQR 13-343). The average dose of vericiguat used was 8.3 ± 2.7 mg and 75 patients achieved the target dose of 10 mg (71%). At the end of follow-up, no significant changes were observed in the values of proBNP (pg/mL), CA125, hemoglobin (mg/dl), electrolytes, glomerular filtration rate (mL/min/m²) and systolic blood pressure (mmHg). Of all the patients who completed follow-up, 11 (11%) discontinued treatment due to adverse effects, mostly symptomatic hypotension, digestive symptoms and pruritus; 25 died (20%).

Conclusions

The use of vericiguat is safe, if used according to the technical data sheet, in terms of the established parameters. Further long-term studies are needed to evaluate the impact of vericiguat as a potential disease-modifying treatment.

本研究的目的是评估现实世界中心力衰竭伴射血分数降低（HFrEF）患者队列的安全性。方法采用观察性、回顾性、单中心研究方法，选取瓦伦西亚总医院联合医院心内科门诊2023年，最少随访6个月，接受验证治疗的患者。纳入根据ESC 2021临床实践指南诊断并优化治疗的HFpEF患者，并开始使用vericiguat治疗。结果我们纳入123例患者，平均年龄78岁，大多数为男性（62%），NYHA II功能状态（52%）。98例患者在中位随访162天（IQR 13-343）后完成随访。vericiguat的平均使用剂量为8.3±2.7 mg， 75例患者达到10 mg的目标剂量（71%）。随访结束时，proBNP （pg/mL）、CA125、血红蛋白（mg/dl）、电解质、肾小球滤过率（mL/min/m2）、收缩压（mmHg）均无明显变化。在所有完成随访的患者中，11例（11%）因不良反应停止治疗，主要是症状性低血压、消化系统症状和瘙痒；死亡25人（20%）。结论按技术资料表规定的参数使用本品是安全的。需要进一步的长期研究来评估vericiguat作为一种潜在的疾病改善治疗的影响。

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引用次数: 0

Modelo de predicción de complicaciones causadas por hipertensión portal o cáncer hepático en una cohorte española de pacientes con hepatitis B crónica 西班牙慢性乙型肝炎患者队列中门脉高血压或肝癌并发症的预测模型

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-04-01 DOI: 10.1016/j.rce.2024.11.003

P. Gavilán , J.-C. Gavilán , E. Clavijo , I. Viciana , J.-A. Gonzalez-Correa

Background aims

To identify risk factors associated with liver complications in patients with chronic hepatitis B infection in an unselected cohort of hepatitis B patients in southern Spain.

Methods

A prospective open-cohort study was conducted on 437 patients with uncomplicated chronic hepatitis B infection in two hospitals in Málaga, southern Spain. The follow-up time ranged from 0.5 to 31.5 years (mean: 13.8 ± 9.5 years; median: 11.4 years). The aim of this study was to evaluate the occurrence of the initial liver complication during follow-up, which is defined as the emergence of liver cancer or complications resulting from portal hypertension. Survival curves were obtained using a time-to-event method through Kaplan-Meier analysis. Multivariate Cox regression was conducted to estimate the hazard ratios of risk factors associated with complications after adjusting for multiple variables. The follow-up of the patients was carried out under conditions of usual clinical practice.

Based on the weighted adjustment of these factors, we developed a Hepatitis B Complication Score (HBCS) from which it was possible to identify patients with low and high risk of complications during follow-up.

Results

33 out of 437 patients (7.55%) experienced liver complications, 12 (36.3%) were secondary to portal hypertension, and 21 patients (63.7%) developed liver cancer. A Multivariate Cox regression identified the following independent risk factor: Age above 45 years: HR 7,10 (2.9-17.3); low platelet count: HR 4,88 (2.1-10.9); hepatitis C coinfection: HR 4.68 (2.0-10.9); Male gender: HR 4.64 (1.5-14.2); alkaline phosphatase above 147 UI/mL: HR 4.33 (2.0-8.9); and Child score above 5 points: HR 3.83 (1.7-8.4). The Risk of Complications Score (HBCS) was developed with a high predictive capacity AUROC 0.92 (0.87-0.97).

Conclusion

An HBCS score greater than 3.07 points identifies patients at high risk of developing complications and with an increased risk of liver and all-cause mortality.

背景目的：在西班牙南部未选择的乙型肝炎患者队列中，确定与慢性乙型肝炎感染患者肝脏并发症相关的危险因素。方法对西班牙南部Málaga两家医院的437例无并发症慢性乙型肝炎感染患者进行前瞻性开放队列研究。随访时间0.5 ~ 31.5年(平均：13.8±9.5年；中位数：11.4年)。本研究的目的是评估随访期间初始肝并发症的发生情况，肝并发症的定义为出现肝癌或门静脉高压引起的并发症。通过Kaplan-Meier分析，采用时间-事件法获得生存曲线。多变量校正后，采用多变量Cox回归估计并发症相关危险因素的危险比。患者的随访在常规临床条件下进行。基于这些因素的加权调整，我们制定了乙型肝炎并发症评分（HBCS），从中可以在随访期间识别出并发症的低风险和高风险患者。结果437例患者中出现肝脏并发症33例（7.55%），继发门静脉高压症12例（36.3%），肝癌21例（63.7%）。多因素Cox回归确定了以下独立危险因素：年龄大于45岁：HR 7,10 (2.9-17.3)；血小板计数低：HR 4,88 (2.1-10.9)；丙型肝炎合并感染：HR 4.68 (2.0-10.9)；男性：HR 4.64 (1.5-14.2)；碱性磷酸酶147 UI/mL以上：HR 4.33 (2.0-8.9)；儿童得分在5分以上：HR 3.83（1.7-8.4）。并发症风险评分（Risk of并发症Score， HBCS）具有较高的预测能力，AUROC为0.92（0.87-0.97）。结论HBCS评分大于3.07分的患者发生并发症的风险高，肝脏和全因死亡的风险增加。

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引用次数: 0

Medicina basada en la complejidad 基于复杂性的医学

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-04-01 DOI: 10.1016/j.rce.2024.12.003

A. Ruiz-Cantero

引用次数: 0

Infección por Helicobacter pylori en los pacientes con enfermedad pulmonar obstructiva crónica. Revisión sistemática y metaanálisis 慢性阻塞性肺病患者幽门螺杆菌感染。系统审查和荟萃分析

IF 2.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Revista clinica espanola

Pub Date : 2025-04-01 DOI: 10.1016/j.rce.2024.12.002

A. González-Saitz , J. Díez-Manglano

Objective

To determine the association of HP infection with COPD, assessing its prevalence and influence on symptoms, lung function, quality of life, exacerbations, hospitalizations, mortality, and healthcare costs.

Methods

We performed a systematic review and meta-analysis after conducting a systematic literature search in PubMed, Embase, Cochrane Library, Virtual Health Library, ScienceDirect, Scopus, Researchgate, and GoogleScholar, from database inception to 31/12/2022. We used the Der Simonian-Laird method to calculate pooled HP prevalence, the Mantel-Haenszel model to determine the association of HP with COPD, and the inverse variance method to compare the pulmonary function tests between infected and uninfected patients, always with a fixed-effect model.

Results

Twenty-eight studies included a total of 8,647 patients with COPD. The pooled prevalence of HP infection was 29.8% (95%CI 29.0-30.7%). The more severe stage of COPD lesser the prevalence of HP (P<.001). HP infection was associated with COPD, estimated odds ratio 1.90 (95%CI 1.71, 2.12), P<.001. The mean differences for p%FEV₁, p%FVC and FEV₁/FVC ratio between HP infected and uninfected patients with COPD were -13.06 (95%CI −14.54, −11.58), −3.72 (95%CI −5.64, −1.79) and −0.01 (95%CI −0.02, −0.00) respectively.

Conclusion

Our meta-analysis suggests an appreciable relationship between HP infection and COPD. Further longitudinal studies considerating confounders and investigating causality are required.

目的确定HP感染与COPD的关系，评估其患病率及其对症状、肺功能、生活质量、病情加重、住院、死亡率和医疗费用的影响。方法系统检索PubMed、Embase、Cochrane Library、Virtual Health Library、ScienceDirect、Scopus、Researchgate和GoogleScholar自数据库建立至2022年12月31日的文献，进行系统综述和meta分析。我们使用Der Simonian-Laird方法计算HP总患病率，使用Mantel-Haenszel模型确定HP与COPD的相关性，使用反方差法比较感染和未感染患者的肺功能测试，均采用固定效应模型。结果28项研究共纳入8,647例COPD患者。HP感染的总患病率为29.8% （95%CI 29.0-30.7%）。COPD越严重，HP患病率越低（p < 0.01）。HP感染与COPD相关，估计优势比1.90 (95%CI 1.71, 2.12), p < 0.01。HP感染与未感染COPD患者的p%FEV1、p%FVC和FEV1/FVC比值的平均差异分别为-13.06 （95%CI−14.54,−11.58）、- 3.72 （95%CI−5.64,−1.79）和- 0.01 （95%CI−0.02,−0.00）。结论：我们的荟萃分析表明HP感染与COPD之间存在明显的关系。需要进一步的纵向研究，考虑混杂因素和调查因果关系。

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引用次数: 0