Cheungpasitporn Wisit, Thongprayoon Charat, Wijarnpreecha Karn, Mitema Donald G, Mao Michael A, Nissaisorakarn Pitchaphon, Podboy Alexander, Kittanamongkolchai Wonngarm, Sakhuja Ankit, Erickson Stephen B
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York, USA.
J Evid Based Med. 2017 Aug;10(3):171-176. doi: 10.1111/jebm.12252. Epub 2017 May 21.
The study's aims were (1) to investigate the prevalence and (2) to assess the risk of Helicobacter pylori (H. pylori) infection in kidney transplant recipients.
A comprehensive literature search was performed from inception until September 2016. Studies that reported prevalence, relative risks, odd ratios, or hazard ratios of H. pylori among kidney transplant recipients were included. Pooled risk ratios and 95% CI were calculated using a random-effect model.
Eleven observational studies with 2545 kidney transplant recipients were enrolled. Between year 1990 and 2000, the estimated prevalence of H. pylori among people with kidney transplant was 50% (95% CI: 31% to 68%), with a prevalence of 46% (95% CI: 23% to 70%) in high-income countries and 55% (95% CI: 22% to 86%) in middle-income countries, respectively. From year 2000 to 2016, the estimated prevalence of H. pylori among people with kidney transplant was 35% (95% CI: 26% to 45%), with a prevalence of 28% (95% CI: 19% to 37%) in high-income countries and 45% (95% CI: 38% to 51%) in middle-income countries. Data regarding prevalence of H. pylori infection in low-income countries were limited. The pooled RR of H. pylori in kidney transplant recipients was 0.57 (95% CI: 0.33 to 1.00) when compared to people with non-transplant.
There has been a decline in prevalence of H. pylori in kidney transplant recipients with the overall estimated prevalence of H. pylori in kidney transplant recipients of 35%, particularly in both high-income and middle-income countries. Also, our meta-analysis demonstrates a potential decreased risk of H. pylori infection in kidney transplant recipients compared with non-transplant populations.
本研究的目的是（1）调查肾移植受者中幽门螺杆菌（H. pylori）感染的患病率，以及（2）评估其感染风险。
从研究起始至2016年9月进行了全面的文献检索。纳入报告肾移植受者中幽门螺杆菌患病率、相对风险、比值比或风险比的研究。使用随机效应模型计算合并风险比和95%置信区间。
纳入了11项观察性研究，共2545名肾移植受者。1990年至2000年期间，肾移植患者中幽门螺杆菌的估计患病率为50%（95%置信区间：31%至68%），其中高收入国家为46%（95%置信区间：23%至70%），中等收入国家为55%（95%置信区间：22%至86%）。2000年至2016年期间，肾移植患者中幽门螺杆菌的估计患病率为35%（95%置信区间：26%至45%），其中高收入国家为28%（95%置信区间：19%至37%），中等收入国家为45%（95%置信区间：38%至51%）。关于低收入国家幽门螺杆菌感染患病率的数据有限。与非移植人群相比，肾移植受者中幽门螺杆菌的合并相对风险为0.57（95%置信区间：0.33至1.00）。
肾移植受者中幽门螺杆菌的患病率有所下降，肾移植受者中幽门螺杆菌的总体估计患病率为35%，在高收入和中等收入国家尤其如此。此外，我们的荟萃分析表明，与非移植人群相比，肾移植受者感染幽门螺杆菌的风险可能降低。
