预先使用质子泵抑制剂对幽门螺杆菌根除率影响的Meta分析

发布时间：2018-12-06 09:07

【摘要】：目的系统评价预先使用质子泵抑制剂(PPI)对幽门螺杆菌(HP)根除率的影响。方法系统检索了PubMed、EMBASE、Cochrane database、Web of Science、Clinical trial.gov、中国生物医学文献数据库、相关期刊论文、万方和维普数据库、Google Scholar的随机对照试验,使用符合方案集分析(PP)比较HP根除率,应用RevMan 5.2进行荟萃分析。结果有10篇文章纳入研究(共982例),除去不符合方案的43例,共纳入939例,预先使用PPI组与对照组相比RR=0.99(95%CI:0.95~1.04,P=0.75),差异无统计学意义。以根除方案为基础行亚组分析,PPI+阿莫西林+克拉霉素组,合并后RR=1.02(95%CI:0.90~1.14,P=0.79),PPI+克拉霉素+甲硝唑组,合并后RR=1.02(95%CI:0.92~1.12,P=0.74),差异均无统计学意义。结论以三联或四联疗法为基础的抗HP方案,预先使用PPI不影响HP根除率。对于临床上HP检测阳性,但已使用PPI的患者,可以选择直接抗HP治疗。
[Abstract]:Objective to evaluate the effect of proton pump inhibitor (PPI) on (HP) eradication rate of Helicobacter pylori. Methods A randomized controlled trial of PubMed,EMBASE,Cochrane database,Web of Science,Clinical trial.gov, Chinese Biomedical Literature Database, Chinese Journal Full-text Database, Wanfang and Weipu databases, Google Scholar was conducted. (PP) was used to compare HP eradication rate and RevMan 5.2 was used for meta-analysis. Results Ten articles were included in the study (982 cases), 43 cases were excluded from the non-conformance scheme and 939 cases were included. There was no significant difference in RR=0.99 (95CI: 0.951.04 P0. 75) between the PPI group and the control group. Subgroup analysis based on eradication program, PPI amoxicillin clarithromycin group, combined RR=1.02 (95 CI: 0.90) 1.14), PPI clarithromycin metronidazole group, combined RR=1.02 (95 CI: 0.92 卤1.12), The difference was not statistically significant. Conclusion the anti-HP regimen based on triple or quadruple therapy does not affect the eradication rate of HP by pre-administration of PPI. Patients who are clinically HP positive, but who have already used PPI, can choose direct anti-HP therapy.
【作者单位】：重庆医科大学附属第二医院消化内科;
【分类号】：R573.1

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