Am J Gastroenterol. 2012 Jul;107(7):1020-1. doi: 10.1038/ajg.2012.174.
Two separate systematic reviews and meta-analyses published in this edition of the American Journal of Gastroenterology conclude that proton pump inhibitor (PPI) use is associated with an ~70% increase in the risk of Clostridium difficile infection (CDI). The two reviews employed different methodology but reached very similar conclusions. However, since the quality of evidence from the individual studies that were included in these analyses is relatively weak, their conclusions must be interpreted cautiously. Observational studies--and even well-conducted systematic reviews of observational studies--rarely provide adequate evidence to prove causality rather than mere association. However, given both the widespread use of PPIs and the increasing incidence and importance of CDI, it is important that this association is adequately explored.
本期《美国胃肠病学杂志》发表的两项独立的系统评价和荟萃分析得出结论，质子泵抑制剂（PPI）的使用与艰难梭菌感染（CDI）的风险增加约 70%有关。这两项综述采用了不同的方法，但得出了非常相似的结论。然而，由于纳入这些分析的个别研究的证据质量相对较弱，因此必须谨慎解释他们的结论。观察性研究——甚至是精心设计的观察性研究系统评价——很少提供足够的证据来证明因果关系，而不仅仅是关联。然而，鉴于质子泵抑制剂的广泛使用以及艰难梭菌感染的发病率和重要性不断增加，充分探讨这种相关性非常重要。
