山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (1): 48-54.doi: 10.6040/j.issn.1673-3770.0.2021.260

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儿童细菌性脑膜炎后听力损害危险因素的系统评价与Meta分析

刘珊珊1, 韩书婧2, 王晓旭1, 李艳红1, 倪鑫1,2, 张杰1   

  1. 1. 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;
    2. 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
  • 发布日期:2022-02-22
  • 通讯作者: 张杰. E-mail:stzhangj@263.net; 倪鑫. E-mail:nixin@bch.com.cn
  • 基金资助:
    北京市医院管理中心儿科学科协同发展中心专项(XTYB201828);北京市医院管理中心“登峰”计划(DFL20191201)

Hearing loss in children after bacterial meningitis: a systematic review and meta-analysis

LIU Shanshan1, HAN Shujing2, WANG Xiaoxu1, LI Yanhong1, NI Xin1,2, ZHANG Jie1   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, National Center for Children's Health China / Beijing Children's Hospital, Capital Medical University, Beijing 100045, China;
    2. National Center for Children's Health China / Beijing Children's Hospital, Capital Medical University / Beijing Pediatric Research Institute / Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head & Neck Surgery, Beijing 100045, China
  • Published:2022-02-22

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摘要： 目的 系统评价儿童细菌性脑膜炎后听力损害的危险因素。 方法 计算机检索PubMed、EMbase、Web of Science、CNKI、Sinomed、Wanfang data、VIP。检索时限为建库~2021年9月20日,收集国内外有关儿童细菌性脑膜炎后听力损害危险因素的相关研究,由两名研究者独立筛选文献、提取资料后,采用纽卡斯尔渥太华量表(NOS)评价研究质量,并采用Stata 16.0软件进行Meta分析。 结果 纳入12项研究(3项队列研究,9项病例对照研究),对2041例细菌性脑膜炎患儿进行了听力检查,其中出现听力损害(特指感音神经性聋)者301例。共对4种危险因素进行Meta分析,显示肺炎链球菌感染［OR=2.70,95%CI(1.89,3.87),P<0.001］、癫痫发作［OR=2.31,95%CI(1.29,4.14),P=0.005］是儿童细菌性脑膜炎后听力损害的危险因素;年龄≤1岁［OR=1.00,95%CI(0.34,2.97),P=0.998］、性别［OR=1.06,95%CI(0.70,1.58),P=0.794］与儿童细菌性脑膜炎后听力损害不相关。 结论 研究的结果表明致病菌为肺炎链球菌、病程中出现癫痫发作是儿童细菌性脑膜炎后听力损害的危险因素。对有上述危险因素的患儿,应格外重视其听力的变化并加强随访。

关键词: 儿童, 细菌性脑膜炎, 听力, 危险因素, Meta 分析

Abstract: Objective To systematically evaluate the risk factors for hearing loss after bacterial meningitis in children. Methods Electronic databases including PubMed, EMbase, Web of Science, CNKI, Sinomed, Wanfang data, and VIP were searched from inception to September 20, 2021 to gather studies published on hearing loss in children after bacterial meningitis. Two authors independently assessed the quality of the studies using the NOS Scale, and a meta-analysis was performed using Stata 16.0 software. Results Twelve studies(3 cohort and 9 case-control studies)measured hearing in a total of 2041 children with bacterial meningitis among whom 301 children suffered sensorineural hearing loss. Meta-analysis was performed for a total of 4 risk factors. Results showed that Streptococcus pneumoniae infection ［OR=2.70, 95%CI(1.89, 3.87), P<0.001］ and seizures ［OR=2.31, 95%CI(1.29, 4.14), P=0.005］ were risk factors for hearing loss after bacterial meningitis; age ≤ 1 year old ［OR=1.00, 95%CI(0.34, 2.97), P=0.998］ and sex ［OR=1.06, 95%CI(0.70, 1.58), P=0.794］ were not associated with hearing loss. Conclusion Current evidence shows that Streptococcus pneumoniae infection and seizures are risk factors for hearing loss after bacterial meningitis. For children with the above risk factors, special attention should be paid to their hearing, and follow-up should be strengthened.

Key words: Children, Bacterial meningitis, Hearing, Risk factors, Meta-analysis

中图分类号: 

  • R764.43+1
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