Sun Jing, Rangan Pooja, Bhat Srinidhi Subraya, Liu Longjian
Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Nesbitt Hall, 3215 Market St., Philadelphia, PA, 19104, USA.
Helicobacter. 2016 Feb;21(1):11-23. doi: 10.1111/hel.12234. Epub 2015 May 22.
The association between helicobacter pylori (Hp) infection and coronary heart disease (CHD) has long been debated, and the results from previous meta-analysis are varied.
The aim for this study was to identify the association between Hp and CHD using published perspective cohort studies.
A systematic review and meta-analysis were performed on studies published from January, 1992 to April, 2014. All studies included used data from prospective cohort studies of CHD events or CHD deaths. Random effect models were applied in all estimations.
H. pylori infection increased the risk of CHD events by 11% (19 studies, n = 22,207, risk ratio (RR) = 1.11, 95% confidence interval (CI): 1.01-1.22). This effect was greater for studies that had less than 5 years' follow-up time (RR = 1.15, 95% CI: 1.00-1.32). However, this effect was not significant for studies that had follow-up times ≥10 years (n = 5100, RR = 1.04, 95% CI: 0.87-1.24). Neither Cag-A seropositive nor Cag-A seronegative strains of H. pylori were associated with a significantly increased risk of CHD events or deaths based on the current published data.
In conclusion, H. pylori infection increased the risk of CHD events, especially in a patient's early life, but this association was weaker or might be masked by other CHD risk factors in long-term observations.
幽门螺杆菌(Hp)感染与冠心病(CHD)之间的关联长期以来一直存在争议,以往的荟萃分析结果各不相同。
本研究的目的是利用已发表的前瞻性队列研究确定Hp与CHD之间的关联。
对1992年1月至2014年4月发表的研究进行系统评价和荟萃分析。所有纳入研究均使用冠心病事件或冠心病死亡前瞻性队列研究的数据。所有估计均采用随机效应模型。
幽门螺杆菌感染使冠心病事件风险增加11%(19项研究,n = 22207,风险比(RR)= 1.11,95%置信区间(CI):1.01 - 1.22)。对于随访时间少于5年的研究,这种效应更大(RR = 1.15,95% CI:1.00 - 1.32)。然而,对于随访时间≥10年的研究,这种效应并不显著(n = 5100,RR = 1.04,95% CI:0.87 - 1.24)。根据目前已发表的数据,幽门螺杆菌的Cag-A血清阳性和Cag-A血清阴性菌株均与冠心病事件或死亡风险的显著增加无关。
总之,幽门螺杆菌感染增加了冠心病事件的风险,尤其是在患者早期,但在长期观察中,这种关联较弱或可能被其他冠心病危险因素所掩盖。