Vergara Mercedes, Calvet Xavier, Roqué Marta
Unitat de Malalties Digestives, Corporació Parc Taulí, Parc Tauli s/n, 08208 Sabadell, Barcelona, Spain.
Eur J Gastroenterol Hepatol. 2002 Jul;14(7):717-22. doi: 10.1097/00042737-200207000-00002.
Peptic ulcer disease is highly prevalent in cirrhosis, and ulcer complications are a major cause of morbidity in these patients. Helicobacter pylori infection is considered the chief aetiological factor of ulcer disease. However, in cirrhotic patients the role of H. pylori in the pathogenesis of peptic ulcer remains uncertain.
To evaluate the evidence of the pathogenic role of H. pylori infection in peptic ulcer disease in patients with cirrhosis.
An extensive MEDLINE search of the literature was performed. Studies reporting the prevalence of H. pylori infection in cirrhotic patients with and without ulcers were selected. Meta-analysis was conducted using RevMan 4.0.3. Pooled odds ratios were calculated for each comparison, using a fixed model analysis.
The search identified seven studies with a total of 976 patients with cirrhosis (275 cases with ulcer disease and 701 controls). The prevalence of H. pylori infection in patients with peptic ulcer disease was higher than in those without. The pooled odds ratio was 2.70 (95% CI, 1.91-3.82). H. pylori infection was associated more or less equally with duodenal and gastric ulcers.
H. pylori infection increases the risk of peptic ulcer disease in patients with cirrhosis.
消化性溃疡病在肝硬化患者中高度流行，溃疡并发症是这些患者发病的主要原因。幽门螺杆菌感染被认为是溃疡病的主要病因。然而，在肝硬化患者中，幽门螺杆菌在消化性溃疡发病机制中的作用仍不确定。
评估幽门螺杆菌感染在肝硬化患者消化性溃疡病发病中的致病作用证据。
对MEDLINE文献进行广泛检索。选择报告有或无溃疡的肝硬化患者中幽门螺杆菌感染率的研究。使用RevMan 4.0.3进行荟萃分析。采用固定模型分析计算每次比较的合并比值比。
检索到7项研究，共976例肝硬化患者（275例溃疡病患者和701例对照）。消化性溃疡病患者中幽门螺杆菌感染率高于无溃疡病患者。合并比值比为2.70（95%可信区间，1.91 - 3.82）。幽门螺杆菌感染与十二指肠溃疡和胃溃疡的关联程度大致相同。
幽门螺杆菌感染增加了肝硬化患者患消化性溃疡病的风险。
