Periodontal status and chronic obstructive pulmonary disease (COPD) exacerbations: a systematic review.
Periodontal status and chronic obstructive pulmonary disease (COPD) exacerbations: a systematic review.
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DOI：
10.1186/s12903-021-01757-z
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发表时间：
2021-09-03
期刊：
影响因子：
2.9
通讯作者：
El Karim IA
中科院分区：
文献类型：
--
作者：
Kelly N;Winning L;Irwin C;Lundy FT;Linden D;McGarvey L;Linden GJ;El Karim IA
越来越多的证据表明口腔细菌在肺部感染中的作用。本系统综述旨在分析牙周状况不良与慢性阻塞性肺疾病（COPD）加重频率之间的关系。检索了PubMed、Embase、Web of Science、CINAHL和Medline中截至2020年5月发表的研究，无语言限制。确定了报告牙周状况或牙周治疗结果的研究，以及COPD恶化频率的数据。主要结局是急性加重的频率，次要结局包括生活质量（QoL）和住院治疗。使用纽卡斯尔渥太华量表进行观察性研究的偏倚质量和风险评估，使用Robins-1工具进行非随机干预研究，使用科克伦偏倚风险评估（RoB-2）工具进行随机临床试验。由两名评估员独立评估研究的合格性和质量。共识别出532条记录，8条符合纳入标准。纳入的研究包括3项临床试验、1项前瞻性队列研究、1项病例对照研究和3项横断面研究。进行叙述性综合。干预研究的数据显示，牙周治疗后病情加重的频率降低。来自观察性研究的数据表明，牙菌斑评分更差和牙齿数量更少与牙菌斑恶化有关，但与牙周袋深度或临床附着丧失无关。更好的牙周健康也与COPD患者COPD恶化、住院和生活质量改善的频率降低相关。由于高度异质性，未进行荟萃分析。一些纳入研究的质量较低，有证据表明偏倚风险较高。这些数据支持COPD患者牙周健康状况差、病情加重频率、住院和生活质量之间可能存在关联。证据的确定性为中度至低度，并且受到高偏倚风险的限制，这表明需要设计良好且具有充分把握度的随机对照试验，以告知未来的研究和临床实践。PROSPERO注册号CRD 42020180328。在线版本包含补充材料，可通过10.1186/s12903-021-01757-z获得。
A growing body of evidence suggests a role for oral bacteria in lung infections. This systematic review aimed to analyse the association between poor periodontal status and the frequency of chronic obstructive pulmonary disease (COPD) exacerbations. PubMed, Embase, Web of Science, CINAHL and Medline were searched for studies published until May 2020, with no language restriction. Studies reporting periodontal condition, or periodontal treatment outcomes, with data on the frequency of exacerbations of COPD, were identified. The primary outcome was the frequency of exacerbations and secondary outcomes included quality of life (QoL) and hospitalisation. Quality and risk of bias assessment were carried out using the Newcastle Ottawa Scale for observational studies, Robins-1 tool for non-randomised intervention studies and Cochrane risk of bias assessment (RoB-2) tool for randomised clinical trials. Studies were assessed for eligibility and quality by two assessors independently. Searches identified 532 records and 8 met the inclusion criteria. Included studies were three clinical trials, one prospective cohort study, one case–control, and three cross-sectional studies. A narrative synthesis was performed. The data from intervention studies showed reduction in the frequency of exacerbations following periodontal treatment. Data from observational studies suggest association of worse plaque scores and fewer teeth with exacerbation, but not pocket depth or clinical attachment loss. Better periodontal health was also associated with reduced frequency of COPD exacerbations, hospitalisations and improved quality of life in COPD patients. Due to the high heterogeneity no meta-analysis was performed. The quality of some of the included studies was low and there was evidence of a high risk of bias. The data supports possible association between poor periodontal health, the frequency of exacerbations, hospitalisation and quality of life in COPD patients. The evidence is of moderate to low certainty and is limited by high risk of bias suggesting the need for well-designed and adequately powered randomised controlled trials, to inform future research and clinical practice. The PROSPERO registration number CRD42020180328. The online version contains supplementary material available at 10.1186/s12903-021-01757-z.
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影响因子：
15.5
作者：
Pragman AA;Lyu T;Baller JA;Gould TJ;Kelly RF;Reilly CS;Isaacson RE;Wendt CH
通讯作者：
Wendt CH
DOI：
10.2147/copd.s194991
发表时间：
2019-01-01
影响因子：
2.8
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
4.3
作者：
Papapanou, Panos N.;Sanz, Mariano;Tonetti, Maurizio S.
通讯作者：
Tonetti, Maurizio S.
影响因子：
24.3
作者：
Roche, N.;Zureik, M.;Perrotin, D.
通讯作者：
Perrotin, D.