【摘要】 目的 系统评价重症监护病房(ICU)患者新型冠状病毒感染(COVID-19)相关肺曲霉病(CAPA)感染危险因素。方法 计算机检索PubMed、Cochrane Library、Embase、Web of Science、中国知网(CNKI)、万方数据、维普数据库(VIP)中关于ICU患者CAPA感染危险因素的研究，检索时限均为建库至2025年3月31日。由2名研究者独立筛选文献与提取资料，采用纽卡斯尔-渥太华(NOS)量表进行质量评价，使用RevMan 5.4软件进行Meta分析。结果 共纳入38篇观察性研究，包括11 312例患者。Meta分析结果显示，男性、年龄、吸烟、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分)、简化急性生理学评分Ⅱ(SAPSⅡ评分)、肝硬化、糖尿病、慢性阻塞性肺疾病(COPD)、心血管疾病、EORTC/MSGERC宿主因素、实体器官移植、血液系统恶性肿瘤、长期使用糖皮质激素、免疫缺陷、Charlson合并症指数、使用血管活性药物和/或正性肌力药物、接受机械通气、侵入性机械通气、机械通气时间、肾脏替代治疗、白细胞介素-6(IL-6)抑制剂治疗等因素均为ICU患者CAPA感染危险因素。身体质量指数(BMI)高和肥胖均为ICU患者CAPA感染的保护性因素(均P<0.05)。结论 ICU患者CAPA感染危险因素较多，及时识别相关危险因素有助于尽早实施规范的抗真菌治疗，从而改善患者预后。更多还原

【Abstract】 Objective To systematically evaluate the risk factors for COVID-19-associated pulmonary aspergillosis(CAPA) in patients in intensive care unit(ICU). Methods Studies on risk factors for CAPA in ICU patients were retrieved from PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure(CNKI), Wanfang Data, and VIP database. The retrieval period was from the establishment dates of all databases to March 31, 2025. Two researchers independently screened literatures and extracted data, evaluated data quality with the Newcastle Ottawa(NOS) scale and conducted Meta-analysis using RevMan 5.4 software. Results A total of 38 observational studies were included in the analysis, including 11 312 patients. Meta-analysis results showed that male, age, smoking, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, simplified acute physiology score Ⅱ(SAPS Ⅱ), liver cirrhosis, diabetes, chronic obstructive pulmonary disease(COPD), cardiovascular disease, EORTC/MSGERC host factors, solid organ transplantation, hematological malignancies, long-term use of glucocorticoids, immunodeficiency, Charlson comorbidity index, using vasoactive drugs and/or positive inotropic drugs, mechanical ventilation, invasive mechanical ventilation, mechanical ventilation duration, renal replacement therapy, interleukin-6 inhibitor therapy were all risk factors for CAPA in ICU patients. High body mass index(BMI) and obesity were protective factors for CAPA in ICU patients(both P<0.05). Conclusion There are multiple risk factors for CAPA in ICU patients. Timely identification of relevant risk factors can help to implement standardized antifungal treatment as early as possible, so as to improve patient prognosis.更多还原