Systematic review and meta-analysis on pulmonary hypertension in patients with combined fibrosis and emphysema syndrome

doi:10.3877/cma.j.issn.1674-6902.2019.03.005

Abstract

Abstract:

Objective

To evaluate systematically the incidence and the level of pulmonary hypertension in the patients with combined pulmonary fibrosis with emphysema (CPFE) syndrome compared with those of the patients with idiopathic pulmonary fibrosis (IPF) or pulmonary emphysema/chronic obstructive pulmonary disease (COPD).

Methods

All the reports about CPFE syndromes were collected by searching these databases including CBM, CNKI, Wan Fang Data, VIP, PubMed, Embase and the Cochrane library (12th in 2017) from January 2005 to January 2018. All the titles/abstracts were reviewed to identify the possible studies with predefined selection criteria. All the data were combined and analyzed using Review Manager 5.3 or Stata 14.0.

Results

A total of 1 385 patients included in 13 reports were selected for this meta-analysis. Compared with the IPF group, the CPFE group had a higher incidence [OR=1.93, 95%CI (1.17, 3.17), P=0.010] and a higher level [MD=11.89, 95%CI (7.39, 16.39), P<0.00001] of pulmonary hypertension. Meanwhile, the incidence [OR=2.62, 95%CI (1.42, 4.81), P=0.002] and the level [MD=7.49, 95%CI (5.27, 9.72), P<0.00001] of pulmonary hypertension also presented higher results compared with the pulmonary emphysema/COPD group.

Conclusion

CPFE syndrome manifests a higher incidence and a higher level of pulmonary hypertension when compared with the IPF group as well as the pulmonary emphysema/COPD group and should be monitored regularly.

Key words: Fibrosis, Pulmonary Emphysema, Pulmonary hypertension, Meta-analysis, Systematic review

Hanyu Shi, Yan Dong, Luqing Wei, Dawei Yin, Qingyun Zong. Systematic review and meta-analysis on pulmonary hypertension in patients with combined fibrosis and emphysema syndrome[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(03): 289-295.

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Figures/Tables 7

References 33

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作　者	研究周期(年)	年龄(CPFE/对照)	研究类型	研究地点	对照组疾病	CPFE(例数)	对照组(例数)	结局指标
赵丽娜2016^[8]	3	71.38±10.14/68.53±7.64	CC	中国，吉林	IPF	21	30	①②
陈锋2016^[12]	6	71.23±7.03/69.96±7.85	Cohort	中国，北京	IPF	21	26	①②
秦文婧2016^[7]	2	85.1±10.6/63.9±8.6/73.9±11.4	CC	中国，河南	IPF＋COPD	34	78(IPF)41(COPD)	①②③④
陈恒屹2014^[21]	3	68.7±4.1/71.1±6.0	Cohort	中国，重庆	IPF	31	36	②
谭晓明2013^[23]	12	84.11±11.00/74.84±13.46/70.86±7.70	CC	中国，北京	IPF＋COPD	55	40(IPF)55(COPD)	①②③④
Ye2014^[22]	4	64±9/66±8	CC	中国，北京	IPF	70	55	①
Zhang2016^[9]	13	66±8.5/60±4.3	Cohort	中国，哈尔滨	IPF	87	105	①
Tomioka2016^[20]	8	76.5±7.1/73.4±9.0	Cohort	日本	COPD	17	49	④
Sugino2013^[19]	7.5	71.4±6.7/73.7±6.3	Cohort	日本	IPF	46	62	②
Sato2016^[10]	3	69.1/68.7	Cohort	日本	IPF	44	38	①
Lee2011^[13]	6	71^a/71	Cohort	韩国	PE	45/135	51/135	③④
Jacob2017^[11]	8	69^a/69	CC	美国	IPF	171	214	①
Mejía2009^[6]	10	63±10/67±7	Cohort	墨西哥	IPF	31	79	①

作　者	研究周期(年)	年龄(CPFE/对照)	研究类型	研究地点	对照组疾病	CPFE(例数)	对照组(例数)	结局指标
赵丽娜2016^[8]	3	71.38±10.14/68.53±7.64	CC	中国，吉林	IPF	21	30	①②
陈锋2016^[12]	6	71.23±7.03/69.96±7.85	Cohort	中国，北京	IPF	21	26	①②
秦文婧2016^[7]	2	85.1±10.6/63.9±8.6/73.9±11.4	CC	中国，河南	IPF＋COPD	34	78(IPF)41(COPD)	①②③④
陈恒屹2014^[21]	3	68.7±4.1/71.1±6.0	Cohort	中国，重庆	IPF	31	36	②
谭晓明2013^[23]	12	84.11±11.00/74.84±13.46/70.86±7.70	CC	中国，北京	IPF＋COPD	55	40(IPF)55(COPD)	①②③④
Ye2014^[22]	4	64±9/66±8	CC	中国，北京	IPF	70	55	①
Zhang2016^[9]	13	66±8.5/60±4.3	Cohort	中国，哈尔滨	IPF	87	105	①
Tomioka2016^[20]	8	76.5±7.1/73.4±9.0	Cohort	日本	COPD	17	49	④
Sugino2013^[19]	7.5	71.4±6.7/73.7±6.3	Cohort	日本	IPF	46	62	②
Sato2016^[10]	3	69.1/68.7	Cohort	日本	IPF	44	38	①
Lee2011^[13]	6	71^a/71	Cohort	韩国	PE	45/135	51/135	③④
Jacob2017^[11]	8	69^a/69	CC	美国	IPF	171	214	①
Mejía2009^[6]	10	63±10/67±7	Cohort	墨西哥	IPF	31	79	①

作　者	研究类型	研究对象选择	可比性	结果/暴露因素测量	总分
赵丽娜2016	CC	★★★	★	★★	6
陈锋2016	Cohort	★★★	★	★★★	7
秦文婧2016	CC	★★★	★	★	5
陈恒屹2014	Cohort	★★★	★	★	6
谭晓明2013	CC	★★★	★	★★	6
Zhang2016	Cohort	★★★	★	★★★	7
Mejia2009	Cohort	★★★	★	★★★	7
Tomiaka2016	Cohort	★★★	★	★★★	7
Sugino2013	Cohort	★★★	★	★★★	7
Sato2016	Cohort	★★★	★	★★	6
Lee2011	Cohort	★★★	★	★★★	7
Jacob2017	CC	★★★	★	★★	6
Ye2014	CC	★★★	★	★★	6

作　者	研究类型	研究对象选择	可比性	结果/暴露因素测量	总分
赵丽娜2016	CC	★★★	★	★★	6
陈锋2016	Cohort	★★★	★	★★★	7
秦文婧2016	CC	★★★	★	★	5
陈恒屹2014	Cohort	★★★	★	★	6
谭晓明2013	CC	★★★	★	★★	6
Zhang2016	Cohort	★★★	★	★★★	7
Mejia2009	Cohort	★★★	★	★★★	7
Tomiaka2016	Cohort	★★★	★	★★★	7
Sugino2013	Cohort	★★★	★	★★★	7
Sato2016	Cohort	★★★	★	★★	6
Lee2011	Cohort	★★★	★	★★★	7
Jacob2017	CC	★★★	★	★★	6
Ye2014	CC	★★★	★	★★	6

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