慢性阻塞性肺疾病患者的微量白蛋白尿：系统综述与荟萃分析。
完整摘要 · 中文译文
背景与目的 我们开展了这项系统评价和荟萃分析，以确定慢性阻塞性肺疾病（COPD）患者中微量白蛋白尿的患病率及其与COPD严重程度的关联。方法 我们在PubMed、Embase、Scopus、Web of Science、Cochrane Library和Virtual Health Library中进行了从建库至2024年12月31日的文献检索。检索策略为：（‘chronic obstructive pulmonary disease’ OR COPD OR ‘chronic airflow obstruction’ OR emphysema OR ‘chronic bronchitis’）AND（microalbuminuria OR albuminuria OR proteinuria OR ‘urinary albumin creatinine ratio’ OR ‘urinary albumin excretion’）。我们纳入了招募经肺量计检查确诊患者并提供微量白蛋白尿患病率数据的研究。我们排除了合并与COPD相关的其他呼吸系统疾病患者的研究，以及发表在掠夺性期刊上的研究。微量白蛋白尿的合并患病率采用DerSimonian-Laird二元随机效应法计算，微量白蛋白尿与COPD及其严重程度的关联采用Mantel-Haenszel随机效应法评估。结果 共纳入25篇文章。COPD患者中微量白蛋白尿的患病率为49.3%[95%置信区间（CI）34.3-64.4%]，高于对照人群，估计比值比为3.94（95%CI 2.25-6.60）。在重度至极重度COPD患者中，其高于轻度至中度COPD患者，估计比值比为4.55（95%CI 2.85-7.28）。合并……的COPD患者 微量白蛋白尿患者的PaO2估计下降9.98 mmHg（95% CI 13.94-6.02），PaCO2估计升高8.08 mmHg（95% CI：4.87-11.29）。解读与结论 微量白蛋白尿在COPD患者中高度流行，其发生率远高于一般人群。它在气流阻塞更严重的患者中更为常见，并与低氧血症和高碳酸血症相关。
完整摘要 · 英文原文
Background and objectives We conducted this systematic review and meta-analysis to determine the prevalence of microalbuminuria in patients with chronic obstructive pulmonary disease (COPD) and its association with COPD severity. Methods We conducted a literature search in PubMed, Embase, Scopus, Web of Science, Cochrane Library, and the Virtual Health Library from inception to December 31th, 2024. The search strategy was: ('chronic obstructive pulmonary disease' OR COPD OR 'chronic airflow obstruction' OR emphysema OR 'chronic bronchitis') AND (microalbuminuria OR albuminuria OR proteinuria OR 'urinary albumin creatinine ratio' OR 'urinary albumin excretion'). We included studies recruiting patients diagnosed by spirometry and providing data of microalbuminuria prevalence. We excluded studies in patients with other respiratory diseases associated with COPD, and studies published in predatory journals. The pooled prevalence of microalbuminuria was calculated using the DerSimonian-Laird binary random effects method, and the association of microalbuminuria with COPD and its severity was assessed using the Mantel-Haenszel random effects method. Results Twenty-five articles were included. The prevalence of microalbuminuria in patients with COPD was 49.3% [95% confidence interval (CI) 34.3-64.4%], which was higher than in the control population, with an estimated odds ratio of 3.94 (95% CI 2.25-6.60). In patients with severe to very severe COPD, it was higher than in those with mild to moderate COPD, with an estimated odds ratio of 4.55 (95%IC 2.85-7.28). Patients with COPD and microalbuminuria had an estimated decrease in PaO2 of 9.98 mmHg (95% CI 13.94-6.02) and an increase in PaCO2 of 8.08 mmHg (95% CI: 4.87-11.29). Interpretations and conclusions Microalbuminuria is highly prevalent in patients with COPD, with a much higher frequency than in the general population. It is more common in patients with more severe airflow obstruction and is associated with hypoxia and hypercapnia.