Meta-analysis Of The Risk Factors On Chronic Obstructive Pulmonary Disease Complicated With Pulmonary Aspergillosis

Background:In recent years,researches at home and abroad have shown that the incidence of chronic obstructive pulmonary disease complicated with pulmonary Aspergillus is increasing.However,these patients' clinical symptoms are lack of specificity,and prognosis is poor.Its‘pathogenesis is complex,thus the etiology is not elucidated.The study of its' risk factors may be helpful for the early detection,prevention and improvement of prognosis.Objective: To systematically evaluate the risk factors of pulmonary aspergillosis in patients with chronic obstructive pulmonary disease and provide the basis for clinical management strategies of COPD patients.Methods: Search Chinese databases(CNKI,VIP and Wangfang)and English databases(PubMed,Embase and Cochrane Library)to collect the case-control studies on the risk factors of pulmonary aspergillosis in COPD from June 1,2000 to June 1,2019.According to the Newcastle-Ottawa scale developed by Wells and etc,the quality of the documents was assessed.Then meta-analysis was performed with Revman 5.3 and stata15 software.Results: A total of 25 documents were included,involving 995 cases and 3117 controls.Meta-analysis showed that the pooled odds ratio(OR)value(95%CI)of smoking history 2.180(1.583~3.001),hospitalization9.270(5.909~12.632),admission to ICU5.169(2.951~9.055),mechanical ventilation 8.617(6.661~11.146),invasive procedures 7.560(5.048~11.323),glucocorticoid 3.497(2.771~4.413),antibiotics 5.616(3.676~8.580),GOLD III-IV 3.364(2.444~4.632),diabetes 2.581(1.444~4.613),fungal colonization or infectious history 4.861(2.324~10.166),hypoalbuminemia6.887(3.647~13.007),APACHII score 5.895(3.976~7.995).Conclusion: The risk factors of pulmonary aspergillosis in COPD are smoking history,long hospital stay,admission to ICU,mechanical ventilation,invasive procedures,glucocorticoid,antibiotics,GOLD III-IV,diabetes,fungal colonization or infectious history,hypoalbuminemia and high APACHII score.Due to existing biases in some factors,further research is needed.