吸入皮质类固醇是否会增加非结核分枝杆菌肺病的风险:一项荟萃分析

Jianfeng Li
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李。吸入皮质类固醇是否会增加非结核分枝杆菌肺病的风险:一项荟萃分析慢性呼吸系统患者应用ICS治疗NTM-PD的生物医学观察。方法:在2019年11月18日之前,应用PubMed、EMBASE和Web of Science数据库筛选符合条件的研究。对慢性呼吸系统患者ICS与NTM-PD相关性的研究进行总结。提取并综合95%置信区间(95% ci)的优势比(ORs)来评估使用ICS后NTM-PD的风险。采用Cochran Q和i平方统计量评估异质性。进行敏感性和亚组分析以追踪异质性的来源。结果:本荟萃分析共纳入5项研究,共纳入20968例慢性呼吸系统患者。使用ICS的NTM-PD风险的总OR为1.97 (95% CI: 1.45-2.67, I2=77.3%, P=0.001)。在敏感性分析中,Bual的研究是异质性的起源。在亚组分析中,哮喘和COPD患者使用ICS有NTM-PD风险增加的趋势。此外,高剂量和当前使用ICS可增加NTM-PD的风险。ICS与NTM-PD风险呈正相关。今后,ICS的选择要更加谨慎。
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"Does Inhaled Corticosteroids Increase the Risk of Nontuberculous Mycobacteria Pulmonary Disease: A Meta-Analysis"
Li. Does Inhaled Corticosteroids Increase the Risk of Nontuberculous Mycobacteria Pulmonary Disease: A Meta-Analysis. Biomed of NTM-PD with the usage of ICS among chronic respiratory patients. Methods: The PubMed, EMBASE and Web of Science databases were applied to identify eligible studies until Nov. 18, 2019. Studies focusing on the correlation between ICS and NTM-PD among chronic respiratory patients were concluded. Odds Ratio (ORs) with 95% confidence intervals (95% CIs) were extracted and synthesized to evaluate the risk of NTM-PD with the usage of ICS. Heterogeneity was assessed by using Cochran Q and I-square statistics. Sensitivity and subgroup analysis were performed to trace the source of heterogeneity. Results: A total of 5 studies with 20968 chronic respiratory patients were enrolled in current meta-analysis. The pooled OR for the risk of NTM-PD with the usage of ICS was 1.97 (95% CI: 1.45—2.67, I2=77.3%, P=0.001). In sensitivity analysis, Bual’s study was the origin of heterogeneity. In the subgroup analysis, there was a trend towards the increased risk of NTM-PD with the usage of ICS among asthma and COPD patients. In addition, high-dose and current usage of ICS could increase the risk of NTM-PD. A positive relationship was the of ICS and the risk of NTM-PD. In the future, the selection of ICS should be more cautious.
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