儿童哮喘及吸入性糖皮质激素对成年终身高影响的系统评价和Meta分析

目的 评价儿童哮喘及应用吸入性糖皮质激素(ICS)对其成年终身高的影响。方法 在PubMed、BCI、EMbase、Web of Science、中国知网和万方数据库中收集2014年10月前有关儿童哮喘和ICS治疗与成年终身高之间关系的研究,并进行系统评价和Meta分析。结果 最终纳入儿童哮喘与成年终身高的相关研究共6项,其中3项研究表明儿童哮喘不影响成年终身高,2项研究表明有轻微影响,且和哮喘严重程度相关,1项研究仅在未接受高等教育的黑人女性亚组发现身高降低。纳入儿童ICS治疗与成年终身高的相关研究共4项,通过ICS治疗组与非ICS治疗组、健康对照组及自身预期终身高的对比,发现哮喘患儿ICS治疗对成年终身高无明显影响。结论 儿童哮喘不会或者仅轻微降低成年终身高,而ICS治疗并不会明显影响成年终身高,但这些结论需要研究进一步验证。

Effects of asthma and inhaled corticosteroids in children on the final adult height: a systemic review and Meta analysis

Objective To evaluate the effects of asthma and inhaled corticosteroids (ICS) in children on the final adult height. Methods A search was performed to collect studies evaluating the relationship between asthma and ICS in children and the final adult height in PubMed, BCI, EMbase, Web of Science, CNKI and Wanfang databases, then a systemic review and Meta analysis were conducted. Results Six studies evaluating the relationship between childhood asthma and the final adult height were enrolled. Three of them indicated that the final adult height was not influenced by childhood asthma. Two of them suggested a mild effect, and the effect was correlated with severity of childhood asthma. One of them indicated that a lower final adult height related to childhhod asthma was found only in black females without a high school education. Four studies evaluating the relationship between ICS and the final adult height were included. Compared with the non-ICS treatment group, healthy control group and the target height, ICS treatment had no effects on the final adult height. Conclusions Childhood asthma does not or only mildly decrease the final adult height. ICS treatment does not significantly affect the final adult height.