Các yếu tố nguy cơ môi trường, yếu tố bảo vệ và dấu hiệu sinh học trong viêm mũi dị ứng: Một cuộc xem xét tổng hợp có hệ thống về bằng chứng

Clinical Reviews in Allergy - Tập 65 - Trang 188-205 - 2023
Xianpeng Xu1,2, Xinghong Liu1,2, Jiongke Li1,2, Xinxing Deng1,2, Tianrong Dai1,2, Qingjie Ji3, Dajing Xiong1,2, Hui Xie1,2
1Department of Otorhinolaryngology, Chengdu University of Traditional Chinese Medicine, Chengdu, China
2Department of Otorhinolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
3Department of Dermatology, Quzhou hospital of Traditional Chinese Medicine, Quzhou, China

Tóm tắt

Nhiều yếu tố nguy cơ môi trường tiềm năng, yếu tố bảo vệ và dấu hiệu sinh học của viêm mũi dị ứng (AR) đã được công bố, nhưng cho đến nay, sức mạnh và độ nhất quán của bằng chứng vẫn chưa rõ ràng. Chúng tôi đã tiến hành một cuộc tổng quan toàn diện về nguy cơ môi trường, yếu tố bảo vệ và dấu hiệu sinh học cho AR nhằm thiết lập hệ thống phân loại bằng chứng. Chúng tôi đã tìm kiếm có hệ thống trong các cơ sở dữ liệu điện tử Embase, PubMed, Cochrane Library và Web of Science từ khi bắt đầu đến ngày 31 tháng 12 năm 2022. Chúng tôi đã tính toán ước lượng hiệu ứng tổng hợp (tỷ lệ odds (OR), nguy cơ tương đối (RR), tỷ lệ rủi ro (HR) và khác biệt trung bình chuẩn (SMD)), khoảng tin cậy 95%, giá trị p dưới tác động ngẫu nhiên, thống kê I2, khoảng dự đoán 95%, hiệu ứng từ các nghiên cứu nhỏ, và thiên lệch ý nghĩa vượt mức, cũng như phân tầng mức độ bằng chứng. Chất lượng phương pháp được đánh giá theo AMSTAR 2 (Công cụ Đo lường Để Đánh giá Các Đánh giá Hệ thống 2). Chúng tôi đã thu thập được 4478 bài báo, trong đó 43 bài đáp ứng tiêu chí bao gồm. 43 bài báo đủ điều kiện đã xác định 31 yếu tố nguy cơ môi trường tiềm năng (10.806.206 dân số tổng cộng, hai nghiên cứu không báo cáo), 11 yếu tố bảo vệ môi trường tiềm năng (823.883 dân số tổng cộng), và 34 dấu hiệu sinh học tiềm năng (158.716 dân số tổng cộng) cho các phân tích tổng hợp. Độ tin cậy của bằng chứng là thuyết phục (loại I) đối với rối loạn tic (OR = 2.89, 95% CI 2.11–3.95); và có tính gợi ý cao (loại II) đối với việc sử dụng kháng sinh trong giai đoạn đầu đời (OR = 3.73, 95% CI 3.06–4.55), tiếp xúc với độ ẩm trong nhà (OR = 1.49, 95% CI 1.27–1.75), tiếp xúc với acetaminophen (OR = 1.54, 95% CI 1.41–1.69), sử dụng thuốc ức chế acid ở trẻ em (OR = 1.40, 95% CI 1.23–1.59), tiếp xúc với nấm mốc trong nhà (OR = 1.66, 95% CI 1.26–2.18), bệnh coronavirus 2019 (OR = 0.11, 95% CI 0.06–0.22), và việc cho bú kéo dài (OR = 0.72, 95% CI 0.65–0.79). Nghiên cứu này đã được đăng ký tại PROSPERO (CRD42022384320).

Từ khóa


Tài liệu tham khảo

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