幽门螺杆菌感染与结直肠息肉发病相关性Meta分析

发布时间：2018-08-17 14:45

【摘要】：目的:探讨人群中幽门螺杆菌(Hp)感染与结直肠息肉发病之间的相关性。并探讨不同Hp检测方法、息肉病理类型、人群地域差异等对Hp感染与结直肠息肉发病相关性的影响。方法:在线检索:MEDLINE、PUBMED、EMBASE和Science Direct数据库,收集从建库至2016年3月关于Hp感染与结直肠息肉发病关系的文献。应用RevMan 5.3软件对符合纳入标准的文献进行Meta分析。结果:共纳入18项研究,总样本量为136126例,其中结直肠息肉72462例,健康对照63664例;结直肠息肉组Hp(+)13193例,健康对照组Hp(+)11452例。Meta分析结果显示结直肠息肉组和健康对照组Hp感染率差异有统计学意义,OR=1.42(95%CI:1.24-1.62,P0.01)。敏感分析提示研究结果较稳健。发表偏倚检测未发现明显发表偏倚存在。基于Hp不同检测方法亚组分析显示,Hp感染与结直肠息肉发病相关性不受Hp检测方法影响,血清学检测:OR=1.64(95%CI:1.43-1.88,P0.01),非血清检测:OR=1.40(95%CI:1.36-1.45,P0.01)。息肉病理类型亚组分析显示,Hp感染与非肿瘤性息肉发病相关性无统计学意义,OR=1.04(95%CI:0.72-1.48,P=0.84),而与肿瘤性息肉发病相关性具有统计学意义,OR=1.47(95%CI:1.31-1.64,P0.01)。在人群地域差异亚组分析中显示,不同地域人群中Hp感染与结直肠息肉发病相关性均具有统计学意义,欧洲:OR=2.00(95%CI:1.49-2.67,P0.01),亚洲:OR=1.42(95%CI:1.31-1.54,P0.01),美洲:OR=1.41(95%CI:1.36-1.46,P0.01)。结论:Hp感染是结直肠息肉发病的危险因素,其感染与结直肠息肉发病相关,尤其与结直肠肿瘤性息肉发病相关,相关性不受Hp检测方法及人群地域不同的影响。
[Abstract]:Objective: to investigate the correlation between Helicobacter pylori (Hp) infection and colorectal polyps. The effects of different HP detection methods, pathological types of polyps and population regional differences on the relationship between HP infection and colorectal polyps were discussed. Methods: the databases of Science Direct and PUBMEDASE were searched online, and the literatures on the relationship between HP infection and colorectal polyps were collected from the establishment of the library to March 2016. RevMan 5.3 software was used for Meta analysis of the literature in accordance with the inclusion criteria. Results: the total sample size was 136126 cases, including 72462 cases of colorectal polyps and 63664 cases of healthy controls, 13193 cases of Hp () in colorectal polyps group, 13193 cases in colorectal polyps group and 13193 cases in healthy controls. Meta-analysis of 11452 cases of Hp () in healthy control group showed that there was significant difference in HP infection rate between colorectal polyp group and healthy control group (95 CI: 1.24-1.62p0.01). Sensitivity analysis indicated that the results of the study were more robust. No obvious publication bias was found in the publication bias test. The subgroup analysis based on different HP detection methods showed that the correlation between HP infection and colorectal polyps was not affected by HP detection method. The serological test was 1. 64 (95 CI: 1. 43-1. 8% P0.01), and the non serum detection was 1. 40 (95 CI: 1. 36-1. 45% P0.01). There was no significant correlation between HP infection and non-tumor polyps (95CI: 0.72-1.48P 0.84), but there was a significant correlation between HP infection and tumor polyps (95CI: 1.31-1.64P 0.01). In the subgroup analysis of population regional differences, the correlation between H.pylori infection and colorectal polyps was statistically significant in different population groups: Europe: 2.00 (95CI: 1.49-2.67 P0.01), Asia: 1.42 (95CI: 1.31-1.54P0.01), America: OR1.41 (95CI: 1.36-1.46P0.01). Conclusion the infection of HP is a risk factor for colorectal polyps. The infection is associated with colorectal polyps, especially colorectal tumor polyps, and the correlation is not affected by HP detection methods and different population regions.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.34

【参考文献】