幽门螺杆菌感染和Barrett食管的相关性Meta分析

The association between helicobacter pylori infection and Barrett′s esophagus:a Meta-analysis

目的探讨幽门螺杆菌（Hp）感染与Barrett食管发生发展的关系。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Hp感染与Barrett食管相关性的病例对照研究。使用RevMan 5.2及Stata 12.0进行Meta分析,采用I2检验判断各研究间的异质性,敏感性分析评估其结果稳定性,应用Begg′s漏斗图和Egger′s回归图评价发表偏倚。结果共纳入14篇文献,病例组2 103例,对照组内镜检查健康者7 009例,胃食管反流性疾病（GERD）患者2 213例。Barrett食管患者的Hp感染率及CagA阳性的Hp感染率,与健康者比较（OR=0.60,95%CI：0.52～0.68;OR=0.24,95%CI：0.11～0.52）;Barrett食管患者的Hp感染率及CagA阳性的Hp感染率,与GERD患者比较（OR=0.02,95%CI：0.06～0.02;OR=0.44,95%CI：0.14～1.45）。结论 Hp尤其是CagA阳性的菌株可能对Barrett食管的发生有保护作用。

Objective To explore the relationship between Helicobacter pylori infection and Barrett′s esophagus.MethodsAdopt the method of combining the computer retrieval and manual retrieval search Pubmed,CNKI,OVID,Wiley InterScience,ten thousand party database,Embase database,the time from the library to January 2014,included in the correlation of helicobacter pylori infection and Barrett′s esophagus case-control study.Using RevMan 5.2and Stata 12.0 Meta analysis,the heterogeneity between studies judgement by using I2 inspection,sensitivity analysis to evaluate its stability as a result,application Begg′s funnel chart and Egger′s return to figure to evaluate publication bias.Results Included 14 articles,Barrett′s esophagus patients 2 103 cases,control group normal persons 7 009 and gastro-esophagealreflux disease patients 2 213.Barrett esophagus in patients with Hp infection rate and CagA positive Hp infection rate,compared with healthy subjects（OR=0.60,95% CI：0.52-0.68）;OR=0.24,95%CI：0.11-0.52）;Barrett esophagus in patients with Hp infection rate and CagA positive Hp infection rate,compared with patients with GERD（OR=0.02,95%CI：0.06-0.02;OR=0.44,95%CI：0.14-1.45）.Conclusion Helicobacter pylori especially CagA-positive strains may have protective effect on Barrett′s esophagus.