自身免疫性甲状腺疾病与幽门螺杆菌感染关系的系统评价

Systematic review on the correlation between autoimmune thyroid diseases and Helicobacter pylori infection

目的系统评价自身免疫性甲状腺疾病(Autoimmune thyroid diseases,AITDs)与幽门螺杆菌(Helicobacter pylori,Hp)感染是否有关,为AITDs的预防和治疗提供新的途径,为AITDs患者是否应积极根除Hp提供参考。方法由2名研究人员独立检索各大型数据库2019年3月之前发表的关于AITDs与Hp感染关系的中英文文献,用Stata 11软件分析,计算合并OR值及其95%CI。结果纳入16项研究进入Meta分析。发现Hp感染与AITDs的发生具有相关性(OR=2.122,95%CI:1.455~3.096);Hp细胞毒素相关蛋白(Hp-CagA)阳性菌株感染增加AITDs发生风险(OR=2.171,95%CI:1.245~3.786);格雷夫斯(Graves)病和桥本甲状腺炎(Hashimoto’s thyroiditis,HT)患者更易感染Hp(GD:OR=3.738,95%CI:2.181~6.405;HT:OR=2.056,95%CI:1.513~2.794)。结论Hp感染与AITDs的发生具有相关性,根除Hp感染可能降低甲状腺自身抗体水平。

OBJECTIVE To systematic review on the correlation between autoimmune thyroid diseases(AITDs)and Helicobacter pylori(H.pylori,Hp)infection,and so as to provides a new approach for the prevention and treatment of AITDs and a reference for actively eradication of Hp in patients with AITDs.METHODS Articles on the correlation between Hp infection and AITDs in English and Chinese,published before March 2019,were independently searched among each major database by two researchers.The odds ratios(OR)and associated 95%confidence intervals[CI]were calculated by Stata 11 software.RESULTS Sixteen papers were included for the meta-analysis.Results showed that Hp infection was positively correlated with the occurrence of AITDs(OR=2.122,95%CI:1.455-3.096).Hp cytotoxin associated protein(Hp-CagA)positive strain infection increased the risk of AITDs(OR=2.171,95%CI:1.245-3.786).Patients with Grave’s disease(GD)and Hashimoto’s thyroiditis(HT)were more susceptible to Hp infection(GD:OR=3.738,95%CI:2.181-6.405;HT:OR=2.056,95%CI:1.513-2.794).CONCLUSION Hp infection was associated with the occurrence of AITDs,and the eradication of Hp infection might reduce thyroid autoantibody levels.