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目的应用循证医学方法探讨中国地区农民肺常见致病菌病因,为预防决策提供依据。方法采用顺查法及追溯法,检索CNKI、维普及Pubmed3个数据库,获得1964～2010年国内外公开发表的关于我国农民肺病原学病例-对照研究文献共7篇,累计实验组715例,对照组712例,使用RevMan5.0软件对其进行Meta综合定量。结果嗜热放线菌与农民肺的发病呈一定的关联性(OR值=24.96,95%CI=9.91～62.86),其中的热吸水链霉菌关联程度最高(OR值=25.52,95%CI=4.94～131.84),其次为普通高温放线菌(OR值=4.21,95%CI=2.60～6.81)、干草小多孢菌(OR值=3.94,95%CI=1.67～9.30)。但是干草小多孢菌组数据经过敏感性分析后,结果缺乏统计学意义(P﹥0.05);其余致病菌因非对照性研究尚无统计学意义。结论导致中国地区农民肺感染的常见病原学为嗜热放线菌,其中以热吸水链霉菌及普通高温放线菌为主;对于干草小多孢菌的致病性尚需要进一步研究。
Objective To explore the etiopathogenisis of common pathogenic bacteria in lung of peasants in China by evidence-based medicine and to provide basis for prevention and decision-making. Methods A total of 7 literatures of case-control study on pneumoconiosis of peasant from 1964 to 2010 in our country were obtained by searching the database of CNKI, VIP and Pubmed by the method of sequential inspection and retrospective analysis. The total number of experimental group was 715, Group 712 cases, the use of RevMan5.0 Meta synthesis of its quantitative. Results The correlation between thermophilic actinomycetes and the incidence of pneumoconiosis in peasants was significant (OR = 24.96, 95% CI = 9.91 ~ 62.86), and the correlation was highest among them (OR = 25.52, 95% CI = 4.94 ~ 131.84), followed by the common high temperature actinomycetes (odds ratio = 4.21, 95% CI = 2.60 ~ 6.81), and hay fever multocida (OR = 3.94,95% CI = 1.67 ~ 9.30). However, after the data were analyzed by sensitivity, the result was not statistically significant (P> 0.05). The other pathogens were still not statistically significant due to the non-control study. Conclusions The common etiology of pneumoconiosis in peasants in China is Thermophilic actinomycetes, which are mainly Streptomyces hygroscopicus and Actinomyces thermophilus. However, the pathogenicity of Microtus fortis needs further study.