幽门螺杆菌感染和Barrett食管相关性的Meta分析

发布时间：2019-02-25 15:47

【摘要】：目的：探讨幽门螺杆菌(包括CagA阳性的幽门螺杆菌)感染与Barrett食管病变之间可能存在的关系。方法：采用计算机检索和手工检索相结合的方法搜索Pubmed、 CNKI、OVID、Wiley InterScience、万方数据库、Embase数据库,时间从建库到2014年1月,纳入分析Barrett食管患者幽门螺杆菌感染率及CagA阳性的幽门螺杆菌感染率,并与胃食管反流性疾病患者及内镜检查正常者比较的病例对照研究。依据纳入和排除标准选择文献,提取相关资料,评价纳入研究文献质量,采用I2检验判断各研究间的异质性,使用RevMan 5.2及Statal2.0进行Meta分析,敏感性分析评估其结果稳定性,应用Begg's漏斗图和Egger's回归图来评价发表偏倚。结果：共纳入14篇文献,病例组Barrett食管患者2103人,对照组内镜检查正常者7009人和胃食管反流性疾病患者2213人。Meta分析结果提示,Barrett食管患者幽门螺杆菌感染率与内镜检查正常者无显著差异[OR 0.60,95% CI(0.52,0.68)], Barrett食管患者CagA阳性的幽门螺杆菌感染率显著低于内镜检查正常者[OR 0.24,95% CI (0.11,0.52)],差异均有统计学意义；Barrett食管患者的幽门螺杆菌感染率及CagA阳性的幽门螺杆菌感染率,与胃食管反流性疾病患者比较[OR 0.02,95% CI(0.06,0.02); OR 0.44,95% CI(0.14,1.45)],差异均无统计学意义。结论：幽门螺杆菌尤其是CagA阳性的菌株可能对Barrett食管的发生有保护作用。
[Abstract]:Objective: to investigate the possible relationship between Helicobacter pylori (including CagA positive Helicobacter pylori) infection and Barrett esophageal lesions. Methods: a combination of computer search and manual search was used to search the Pubmed, CNKI,OVID,Wiley InterScience, Wanfang database and the Embase database. The time from the establishment of the database to January 2014. A case-control study was carried out to analyze the infection rate of Helicobacter pylori (HP) and CagA-positive Helicobacter pylori (HP) in patients with Barrett esophagus and those with gastroesophageal reflux disease (GERD) and those with normal endoscopy. According to the criteria of inclusion and exclusion, the literature was selected, the relevant data were extracted, the quality of the research literature was evaluated, the heterogeneity among the studies was judged by I2 test, and the Meta analysis was carried out with RevMan 5.2and Statal2.0. Sensitivity analysis was used to evaluate the stability of the results. Begg's funnel diagram and Egger's regression diagram were used to evaluate publication bias. Results: a total of 14 articles were included, including 2103 patients with Barrett's esophagus in the case group, 7009 patients with normal endoscopy and 2213 patients with gastroesophageal reflux disease (GERD) in the control group. There was no significant difference in Helicobacter pylori infection rate between patients with Barrett esophagus and those with normal endoscopy [OR 0.60,95% CI (0.52, 0.68)]. The infection rate of CagA positive Helicobacter pylori in patients with Barrett esophagus was significantly lower than that in patients with normal endoscopy [OR 0.24, 95% CI (0.11, 0.52)], the difference was statistically significant. The infection rate of Helicobacter pylori and the infection rate of CagA positive Helicobacter pylori in patients with Barrett esophagus were significantly higher than those in patients with gastroesophageal reflux disease [OR 0.02, 95% CI (0.06, 0.02); There was no significant difference in OR 0.44 and 95% CI (0.14, 1.45). Conclusion: Helicobacter pylori, especially CagA positive strains, may have protective effect on the development of Barrett esophagus.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R571;R573

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