Yuan Wenzhen, Wang Donghai, Yang Lijuan
The First Hospital of Lanzhou University, The Evidence-Based Medicine Center of Lanzhou University, Lanzhou, China.
Scand J Gastroenterol. 2010 Jun;45(6):665-76. doi: 10.3109/00365521003663670.
Helicobacter pylori (H. pylori) infection and iron deficiency anemia are prevalent in disadvantaged populations worldwide. The benefit of H. pylori eradiation for iron deficiency anemia has been extensively studied, but data are still equivocal.
A search in The Cochrane Library, PUBMED, EMBASE, EBM Review databases, Science Citation Index Expanded, and CMB (Chinese Biomedical Literature Database) was performed. Randomized controlled trials (RCTs) comparing anti-H. pylori plus oral iron to oral iron alone for the iron deficiency patients in whom H. pylori was positive were selected for meta-analysis. Reviev Manager 5.0 software was used for the performance of meta-analysis.
Sixteen randomized controlled trials totaling 956 patients were included. The meta-analysis showed that the difference from baseline to endpoint of hemoglobin (Hb), serum iron (SI), and serum ferritin (SF) was statistically significantly different between anti-H. pylori treatment plus oral iron and oral iron alone (SMD, Hb 1.48; 95% CI, 0.96, 2.00; p < 0.00001; SI 1.15; 95% CI, 0.87, 1.43; p < 0.00001; SF 1.84; 95% CI, 1.20, 2.48; p < 0.00001, respectively).
Our study suggests that treatment of H. pylori infection could be effective in improving anemia and iron statue in IDA patients infected by H. pylori, particularly in patients with moderate or severe anemia.
幽门螺杆菌(H. pylori)感染和缺铁性贫血在全球弱势群体中普遍存在。幽门螺杆菌根除治疗对缺铁性贫血的益处已得到广泛研究,但数据仍不明确。
检索了Cochrane图书馆、PUBMED、EMBASE、循证医学评价数据库、科学引文索引扩展版和中国生物医学文献数据库。选择比较抗幽门螺杆菌治疗加口服铁剂与单纯口服铁剂治疗幽门螺杆菌阳性缺铁患者的随机对照试验(RCT)进行荟萃分析。使用Reviev Manager 5.0软件进行荟萃分析。
纳入16项随机对照试验,共956例患者。荟萃分析表明,抗幽门螺杆菌治疗加口服铁剂与单纯口服铁剂相比,血红蛋白(Hb)、血清铁(SI)和血清铁蛋白(SF)从基线到终点的差异有统计学意义(标准化均数差,Hb 1.48;95%可信区间,0.96,2.00;p<0.00001;SI 1.15;95%可信区间,0.87,1.43;p<0.00001;SF 1.84;95%可信区间,1.20,2.48;p<0.00001)。
我们的研究表明,治疗幽门螺杆菌感染对改善幽门螺杆菌感染的缺铁性贫血患者的贫血和铁状态有效,特别是对中度或重度贫血患者。