具核梭杆菌感染对炎症性肠病患者病情进展影响的meta分析

Influence of Fusobacterium nucleatum infection on the progression of inflammatory bowel disease:A meta analysis

目的通过meta分析明确具核梭杆菌(Fn)感染是否会加重炎症性肠病(IBD)患者病情并增加其治疗难度。方法计算机检索PubMed、MEDLINE、EMBASE、Web of Science、万方医学网、中国知网等数据库,时限为1988年1月至2022年6月。通过纳入及排除标准进行筛选文献及提取资料。采用STATA12.0软件进行meta分析。结果共纳入病例对照研究文献6篇。与未感染患者比较,Fn感染IBD患者临床炎症活动度明显加重、需要手术治疗者明显增加,差异均有统计学意义[优势比(OR)=4.13、3.90,95%可信区间(95%CI):2.08~8.23、1.22~12.45];Fn感染IBD患者年龄、性别、炎症部位、临床进程、难治性与未感染患者比较,差异均无统计学意义(OR=0.76、1.51、1.59、1.94、1.80,95%CI:0.39~1.50、0.86~2.64、0.90~2.80、0.41~9.09、0.07~49.84)。采用逐一排除方法进行敏感性分析,临床活动度OR结果稳定。结论Fn感染可能会导致IBD患者病情加重,并导致需要手术治疗的风险明显增加,IBD患者如合并Fn感染可能需要使用抗生素治疗,但尚有待于更多前瞻性研究进一步证实。

Objective To determine whether Fusobacterium nucleatum(Fn)infection will aggravate the condition of patients with inflammatory bowel disease(IBD)and make it more difficult to treat them by meta analysis.Methods PubMed,MEDLINE,EMBASE,Web of Science,Wanfang database and China National Knowledge Infrastructure and other databases were searched by computer,the time limit was from January 1988 to June 2022.The inclusion and exclusion criteria were used to screen literatures and extract data.Meta analysis was performed by stata 12.0 software.Results A total of six case-control studies were included.Compared with the uninfected patients,the clinical inflammatory activity of IBD patients with Fn infection was significantly increased,and the number of patients required surgical treatment was also significantly increased,with statistical significance[odds ratio(OR)=4.13,3.90,95%confidence interval(95%CI):2.08-8.23,1.22-12.45].Compared with uninfected patients,there were no significant differences in age,gender,inflammatory site,clinical progress and refractory of IBD patients with Fn infection(OR=0.76,1.51,1.59,1.94,1.80;95%CI:0.39-1.50,0.86-2.64,0.90-2.80,0.41-9.09,0.07-49.84).One by one exclusion method was used for sensitivity analysis,and the OR value of clinical activity was stable.Conclusion Fn infection may aggravate the condition of patients with IBD,and increase the risk of surgical treatment obviously.The IBD patients with Fn infection may need antibiotic treatment.These results need to be further confirmed by more prospective studies.