Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; First Clinical Medical College of Nanjing Medical University, Nanjing 210029, China.
Gastroenterol Res Pract. 2013;2013:785892. doi: 10.1155/2013/785892. Epub 2013 Nov 7.
Background. Infection with Helicobacter pylori contributes to the etiopathogenesis of various extragastrointestinal conditions, yet its etiological association with either symptomatic or asymptomatic dialysis patients remains inconclusive. Methods. Two researchers working independently conducted a literature search of the online databases PubMed, EMBase, ScienceDirect, and Cochrane Central Register of Controlled Trials to identify relevant articles to the end of 2012. Case-control and cross-sectional studies that met the inclusion criteria were included. Results. Fifteen studies involving 1237 dialysis patients and 1568 controls with normal renal function were included. Compared with normal controls, dialysis patients overall were associated with a relatively lower risk of H. pylori infection though not statistically significant. A significant inverse association was found between H. pylori prevalence and duration of treatments in those who were dialyzed >4 years (odds ratio 0.28; 95% confidence interval 0.22-0.36, P < 0.00001). No relationship between H. pylori status and duration of dialysis was observed in CRF patients. There were no significant differences in endoscopic features between patients and controls. Conclusions. Our meta-analysis found no evidence of a significant association between infection with H. pylori and dialysis overall, whereas long-term treatments of more than four years had a significant protective effect.
幽门螺杆菌感染是导致各种胃肠道外疾病的病因之一,但其与有症状或无症状透析患者的病因关联仍不明确。
两位独立的研究人员对在线数据库 PubMed、EMBase、ScienceDirect 和 Cochrane 对照试验中心注册库进行了文献检索,以查找截至 2012 年底的相关文章。纳入符合纳入标准的病例对照和横断面研究。
共纳入 15 项研究,涉及 1237 例透析患者和 1568 例肾功能正常的对照者。与正常对照组相比,透析患者总体上感染幽门螺杆菌的风险相对较低,但无统计学意义。对于透析时间>4 年的患者,幽门螺杆菌的流行率与治疗时间之间存在显著的负相关(比值比 0.28;95%置信区间 0.22-0.36,P<0.00001)。在慢性肾功能衰竭患者中,未观察到幽门螺杆菌状态与透析时间之间存在关系。患者和对照组之间的内镜特征没有显著差异。
我们的荟萃分析没有发现幽门螺杆菌感染与透析之间存在显著关联的证据,而超过 4 年的长期治疗具有显著的保护作用。