幽门螺旋杆菌感染与炎症性肠炎发病的meta分析 - 第三军医大学学报.DOC

幽门螺旋杆菌感染与炎症性肠炎发病的meta分析 米琛1，宋政军1，厉英超1，朱占芳2 （1.西安交通大学医学院第一附属医院 消化内科 710061 2.西安交通大学医院 710049 ） 【摘要】目的 探讨幽门螺杆菌与炎症性肠炎发生率的关系。方法 按照系统评价的要求全面检索PubMed, Medline, 以及EMBASE等1980至2010年所有研究幽门螺杆菌与炎症性肠炎的试验，对符合纳入标准的24篇文献共计6103名患者进行了meta分析。结果 研究分析发现纳入文献可能存在异质性，采用随机模型进行分析，合并后RR值及95%可信区间为0.64(0.56,0.73)，提示幽门螺旋杆菌感染对炎症性肠炎有保护作用。纳入文献可能存在发表偏倚，但经过敏感性分析合并结果可信。结论 从现有的调查研究结果证据来看，幽门螺旋杆菌感染是炎症性肠炎的一个保护因素，但由于存在异质性和发表偏倚，还需要更多证据进一步进行证实。 关键词：幽门螺旋杆菌；炎症性肠炎；Crohn病；溃疡性结肠炎；meta分析 Association Between Helicobacter pylori Infection and In?ammatory Bowel Disease: A Meta-analysis Mi Chen, Song Zhengjun, Li Yingchao, Zhu Zhanfang Department, First Affiliated Hospital of Medical College, Xi’an Jiaotong University, Xi’an, P. R China 710061 Xi’an Jiaotong University Hospital , Xi’an, P. R China 710049 【Abstract】Objective To systematically evaluate the ssociation Between Helicobacter pylori Infection and In?ammatory Bowel Disease. Methods According to the requirements of Cochrane systematic review, a thorough literature search was performed among PubMed, Medline, and EMBASE from 1990 to 2010 in any language, were searched for studies relevant to in?ammatory bowel disease and Helicobacter pylori. Results In the forest plot, the 95% CI horizontal line of incorporation odds ratio droped to the left side of the vertical line[0.64(0.56,0.73)], indicating the border of association. Twenty-four placebo-controlled, RCTs (6103 subject) were included. est for heterogeneity showed that all studies had clinical heterogeneity, which allowed to use random effect model analysis. Publication bias analysis showed that the funnel plot was non-symmetrical, but the sensitivity analysis show the conclusion was credible. Conclusions These results suggest a protective bene?t of H. pylori infection against the development of IBD. Heterogeneity among studies and the possibility of publication bias limit the certainty of this ?nding. Further studies investigating the effect of eradication of H. pylori on the development of IBD a