幽门螺杆菌感染和 Barrett 食管的相关性 Meta 分析

摘要

Objective To explore the relationship between Helicobacter pylori infection and Barrett′s esophagus.Methods Adopt 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 py-lori infection and Barrett′s esophagus case-control study.Using RevMan 5.2 and Stata 12.0 Meta analysis,the heterogeneity be-tween studies judgement by using I 2 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 ca-ses,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 :0.1 1-0.52);Barrett esophagus in patients with Hp infection rate and CagA positive Hp infection rate,compared with pa-tients 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.%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 I 2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2103例,对照组内镜检查健康者7009例,胃食管反流性疾病(GERD)患者2213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。