胃食管反流病患者幽门螺杆菌感染率的Meta分析

Infection rate of Helicobacter pylori in patients with gastroesophageal reflux disease: a Meta-analysis

目的对近15年来有关幽门螺杆菌(Helicobacter pylori,Hp)与胃食管反流病(gastroesophageal reflux disease,GERD)的国内外21篇文献进行Meta分析,探讨Hp与GERD的关系。方法在Pubmed、Ovid、中国知网、万方等数据库检索2001-2016年公开发表的有关Hp与GERD的中外文文献,并对文献进行筛选,应用Stata12.0软件进行数据分析。结果对最终纳入的21篇文献分析显示:(1)GERD组Hp感染率低于正常对照组(OR=0.56,95%CI:0.46~0.68);(2)GERD中糜烂性食管炎(erosive esophagitis,EE)分型组Hp感染率低于正常对照组(OR=0.46,95%CI:0.35~0.61);(3)GERD中Barrett食管(Barrett's esophagus,BE)分型组Hp感染率均低于正常对照组(OR=0.43,95%CI:0.30~0.62);(4)EE组LA-CD与LA-AB间比较差异无统计学意义(OR=0.39,95%CI:0.10~1.57)。结论 GERD患者Hp感染率较正常人低,推测Hp可能对GERD具有保护作用,与EE严重程度无关。

Objective To analyze21documents published in Chinese and foreign languages aboutHelicobacter pylori(Hp)and gastroesophageal reflux disease(GERD)in the past15years by Meta-analysis,and to investigate the relationship between Hp and GERD.Methods The Chinese and foreign literaturesabout Hp and GERD published from2001to2016were searched and screened through PubMed,Ovid,ChinaNational Knowledge Infrastructure(CNKI)and Wanfang Database.The data were analyzed by using Statal2.0software.Results The analysis results of21studies showed that:①The infection rate of Hp in GERD groupwas lower than that in the normal control group(OR=0.56,95%CI:0.46-0.68);(2)The infection rate of Hpin erosive esophagitis(EE)typing of GERD was lower than that in the normal control group(OR=0.46,95%C/:0.35-0.61);③The infection rate of Hp in Barrett's esophagus(BE)typing of GERD was lower than thatin the normal control group(OR=0.43,95%CI:0.30-0.62);(J)There was no significant difference betweenLA-CD and LA-AB of EE(OR=0.39,95%CI:0.10-1.57).Conclusions The infection rate of Hp inGERD patients is lower than that in the normal people.We speculate that Hp may have a protective effect onGERD and not be relevant to the severity of EE.