山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (5): 132-138.doi: 10.6040/j.issn.1673-3770.0.2018.603

• 荟萃分析 • 上一篇    

慢性鼻-鼻窦炎的微生态Meta分析

韩书婧1,鲁洁1,初平1,唐力行2,郑惠文1,杨小健2,张薇2,王蓬鹏2,张杰2,郭永丽1,葛文彤1,2()   

  1. 1. 国家儿童医学中心,首都医科大学附属北京儿童医院,北京市儿科研究所,儿童耳鼻喉头颈外科疾病北京市重点实验室,北京 100045
    2. 国家儿童医学中心,首都医科大学附属北京儿童医院 耳鼻咽喉头颈外科,北京 100045
  • 收稿日期:2018-12-11 修回日期:2019-05-07 出版日期:2019-09-20 发布日期:2019-10-15
  • 通讯作者: 葛文彤 E-mail:gewentong@bch.com.cn
  • 基金资助:
    北京市医院管理局“青苗”计划专项项目(QML20171202);北京市卫生系统高层次卫生技术人才学科骨干项目(20153079)

Meta analysis of the nasal cavity bacterial culture in chronic rhinosinusitis

Shujing HAN1,Jie LU1,Ping CHU1,Lixing TANG2,Huiwen ZHENG1,Xiaojian YANG2,Wei ZHANG2,Pengpeng WANG2,Jie ZHANG2,Yongli GUO1,Wentong GE1,2()   

  1. 1. Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health (NCCH), Beijing 100045,China
    2. Department of Otolaryngology Head and Neck Surgery, Beijing Children′s Hospital, Capital Medical University, National Center for Children′s Health (NCCH), Beijing 100045,China
  • Received:2018-12-11 Revised:2019-05-07 Online:2019-09-20 Published:2019-10-15
  • Contact: Wentong GE E-mail:gewentong@bch.com.cn

摘要: 目的

明确慢性鼻-鼻窦炎患者鼻腔的菌群分布情况,为指导慢性鼻-鼻窦炎的诊疗提供依据。

方法

通过PubMed、EMBASE和MEDLINE数据库检索英文文献,通过中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、万方数据库系统检索中文文献,收集各数据库自建库至2018年9月发表的所有慢性鼻-鼻窦炎微生态(包括细菌和病毒)分布情况研究的文献全文。检索策略:英文检索(chronic rhinosinusitis) AND (microbio* OR bacteria OR virus);中文检索(鼻-鼻窦炎) 并且 (微生态 或者 细菌 或者 病毒)。

结果

共纳入20篇文献,共计2    141例慢性鼻-鼻窦炎,金黄色葡萄球菌阳性率为0.24(95%CI: 0.17~0.31),表面葡萄球菌阳性率0.17(95%CI:0.11~0.23),肺炎链球菌阳性率0.06(95%CI:0.02~0.11)、铜绿假单胞杆菌阳性率0.09(95%CI:0.05~0.14)、流感嗜血杆菌阳性率0.09(95%CI:0.03~0.15)。

结论

在慢性鼻-鼻窦炎患者鼻腔中,金黄色葡萄球菌、表面葡萄球菌是主要的致病菌,其次阳性率较低的是肺炎链球菌、铜绿假单胞杆菌和流感嗜血杆菌。

关键词: 鼻-鼻窦炎, 菌群, Meta分析

Abstract: Objective

To clarify the bacterial distribution in the nasal cavity of patients with chronic rhinosinusitis and provide a basis for the diagnosis and treatment of Chronic Rhinosinusitis (CRS).

Methods

PubMed, EMBASE, MEDLINE, CNKI, VIP Information and Wanfang data were searched for studies on the nasal cavity bacterial culture in CRS. Search strategy: chronic rhinosinusitis AND (microbio* OR bacteria OR virus); Chinese retrieval (rhinosinusitis) AND (microecology OR bacteria OR virus).

Results

Totally, 2141 cases of CRS were included in 20 studies. The pooled positive rates of Staphylococcus aureus, S. epidermidis, Streptococcus pneumoniae, Pseudomonas aeruginosa and Haemophilus influenzae were 0.24(95%CI: 0.17 ~ 0.31), 0.17(95%CI: 0.11 ~ 0.23), 0.06(95%CI: 0.02 ~ 0.11), 0.09(95%CI: 0.05 ~ 0.14), and 0.09(95%CI: 0.03 ~ 0.15), respectively.

Conclusion

S. aureus and S. epidermidis are the main pathogenic bacteria present in the nasal cavity of CRS patients, followed by S. pneumoniae, P. aeruginosa, and H. influenzae.

Key words: Chronic rhinosinusitis, Bacteria culture, Meta analysis

中图分类号: 

  • R765.4

表 1

纳入细菌分布相关文献的数据汇总"

作者 发表时间(年) 国家 样本量(例) 男(例) 年龄(岁) 取样部位 金黄色葡萄球菌 肺炎链球菌 表面葡萄球菌 卡他莫拉菌 铜绿假单胞杆菌 CNS 流感嗜血杆菌 大肠埃希菌 奇异变形杆菌 甲型链球菌 肺炎克雷伯菌
Araujo E等[4] 2007 Brazil 134 NA NA 中鼻道 53 22 19 13 10
Bro?ekm?dry等[11] 2012 Poland 64 NA 5-18 中鼻道 33 2 7 35 11
Busaba等[12] 2004 USA 179 74 NA 中鼻道 33 7 5 9 8 8
Chan 等[13] 2001 USA 83 NA NA 中鼻道 2 10 8 6 26 21
Cleland 等[14] 2013 Australia 513 280 51

鼻腔黏液、

黏膜

178 26 10 44 23 19
Feazel 等[15] 2012 USA 15 5 45 中鼻道 10 15 18
Jiang等[16] 2015 USA 105 46 46.3 中鼻道 31 6 6 25 6 15
Mantovani等[17] 2010 Brazil 62 30 45 上颌窦 4 3 4 8 1 2 15
Niederfuhr等[18] 2009 Germany 13 9 49 鼻腔灌洗液 1 2 12 4 1
Rombaux等[19] 2005 Belgium 176 NA NA 中鼻道 37 5 7 11
Stokken等[20] 2014 USA 41 29 11.8 中鼻道 8 4 1 9 2
Walgama等[21] 2013 USA 49 20 49.2 中鼻道 22 1 15 1 3
李军等[22] 2016 China 175 104 43 上颌窦及筛窦 26 1 41 6 6 1 1
魏洪政等[23] 2017 China 125 85 45.5 中鼻道 13 25 9 40 4 1
张太等[24] 2016 China 63 40 46.25 中鼻道 6 6 3 1
何文霞等[25] 2015 China 100 56 32.6 上颌窦 22 6 10
王士杰等[26] 2015 China 43 28 45.2 中鼻道 4 2 6 5 2 1
肖立志等[27] 2011 China 51 27 44 鼻腔黏液 1 1 17 2
张永兰等[28] 2015 China 63 39 47 中鼻道 6 4 3 1
林华等[29] 2015 China 87 49 44.6 鼻腔分泌物 23 12 15 10 5

表 2

纳入病毒分布相关文献的数据汇总"

作者 发表时间(年) 国家 样本量(例) 男(例) 年龄(岁) 取样部位 检测方法 鼻病毒 呼吸道合胞病毒 流感病毒A和B群 副流感病毒
Abshirini等[30] 2015 IR Iran 76 48 44.3 鼻腔黏液 qPCR 28 15
Cho等[31] 2013 Republic of Korea 111 67 72.8 鼻腔灌洗液 qPCR 29 12 15 26
Liao等[32] 2014 China 61 44 28 中鼻道黏膜 qPCR 5 22 18

图 1

金黄色葡萄球菌阳性率的Meta分析森林图"

图 2

表面葡萄球菌阳性率的Meta分析森林图"

图 3

肺炎链球菌阳性率的Meta分析森林图"

图 4

铜绿假单胞杆菌阳性率的Meta分析森林图"

图 5

流感嗜血杆菌阳性率的Meta分析森林图"

图 6

金黄色葡萄球菌阳性率各研究发表偏倚的漏斗图"

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