不同疗法对重症发热和血小板减少综合征患者侵袭性肺曲霉病的影响：系统综述和荟萃分析
The impact of different therapies on invasive pulmonary aspergillosis in patients with severe fever and thrombocytopenia syndrome: a systematic review and meta-analysis.
摘要(中文译文)
近年来，越来越多的研究报告显示，重型发热伴血小板减少综合征（SFTS）相关侵袭性肺曲霉病（SAPA）患者具有相对较高的发病率和死亡率。然而，各项研究的结论差异较大，且SFTS患者常接受糖皮质激素治疗等免疫抑制治疗，其对SAPA发病率的影响仍不确定。因此，本研究拟开展一项全面的系统评价和荟萃分析，以整合现有证据。效应估计值以SAPA发病率、比值比（OR）及95%置信区间（CI）表示。按照检索策略，在PubMed、Web of Science和Embase数据库中进行了全面检索。经过详细评估，共有10篇文章符合纳入标准并纳入本研究。结果表明，SFTS患者中SAPA的发病率为27.4%（95% CI：18.9-35.9%，I = 95.60%）。SAPA患者的死亡风险显著高于非SAPA患者：OR = 5.381（95% CI：3.666-7.899，I = 0.00%）。包括糖皮质激素（OR = 3.104，95% CI：2.410-3.998，I = 35.70%）、静脉注射免疫球蛋白（IVIG）（OR = 3.952，95% CI：1.876-8.326，I = 77.70%）、抗生素（OR = 16.419，95% CI：8.489-31.756）及机械通气（OR = 6.456，95% CI：4.362-9.554，I = 43.80%，= 0.169）在内的治疗与SAPA发生几率升高相关。本研究表明，SAPA的发病率及相关死亡风险相对较高。此外，包括糖皮质激素、IVIG、抗生素及机械通气在内的治疗与SAPA发生几率升高相关。临床医生应高度警惕SAPA，当怀疑或确诊SAPA时，应考虑早期诊断检测和及时的抗真菌治疗。CRD420261343968。
Abstract
In recent years, a growing number of studies have reported that patients with severe fever with thrombocytopenia syndrome (SFTS)-associated invasive pulmonary aspergillosis (SAPA) patients exhibit a relatively high incidence and mortality rate. However, the conclusions vary considerably and SFTS patients frequently receive immunosuppressive therapies such as corticosteroid therapy, and the influence on the incidence of SAPA remains uncertain. Therefore, this study intends to conduct a comprehensive systematic review and meta-analysis to consolidate existing evidence. Effect estimates were expressed as incidence of SAPA, odds ratio (OR) and 95% confidence intervals (CI). According to the search strategy, a comprehensive search was carried out in the PubMed, Web of Science, and Embase databases. After a detailed assessment, 10 articles met the inclusion criteria and were included in this study. The results indicate that the incidence of SAPA in SFTS patients is 27.4% (95% CI: 18.9-35.9%, I = 95.60%). The mortality risk among SAPA patients was significantly higher than that among non-SAPA patients: OR = 5.381 (95% CI: 3.666-7.899, I = 0.00%). Therapies including corticosteroid (OR = 3.104, 95% CI: 2.410-3.998, I = 35.70%), intravenous immunoglobulin (IVIG) (OR = 3.952, 95% CI: 1.876-8.326, I = 77.70%), antibiotics (OR = 16.419, 95% CI: 8.489-31.756), and mechanical ventilation (OR = 6.456, 95% CI: 4.362-9.554, I = 43.80%, = 0.169) are associated with higher odds of SAPA. Our study indicates that the incidence of SAPA and the associated mortality risk are relatively high. Moreover, therapies including corticosteroids, IVIG, antibiotics, and mechanical ventilation are associated with higher odds of SAPA. Clinicians should maintain a high index of suspicion for SAPA and consider early diagnostic testing and timely antifungal therapy when SAPA is suspected or confirmed. CRD420261343968.
如何引用
AMA
Feng Hao, Yingzi Wang, Siyu Qu, Liquan Zhang, Wenhua Zhang, Lili Wei, et al. The impact of different therapies on invasive pulmonary aspergillosis in patients with severe fever and thrombocytopenia syndrome: a systematic review and meta-analysis.. Frontiers in public health. 2026; doi:10.3389/fpubh.2026.1834363.
APA
Feng Hao, Yingzi Wang, Siyu Qu, Liquan Zhang, Wenhua Zhang, Lili Wei, et al (2026). The impact of different therapies on invasive pulmonary aspergillosis in patients with severe fever and thrombocytopenia syndrome: a systematic review and meta-analysis.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1834363
GB/T 7714
Feng Hao, Yingzi Wang, Siyu Qu, Liquan Zhang, Wenhua Zhang, Lili Wei, et al. The impact of different therapies on invasive pulmonary aspergillosis in patients with severe fever and thrombocytopenia syndrome: a systematic review and meta-analysis.[J]. Frontiers in public health, 2026 doi:10.3389/fpubh.2026.1834363.
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