Department of Gastroenterology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China.
Graduate school, Dalian Medical University, Dalian, Liaoning Province, China.
Helicobacter. 2022 Feb;27(1):e12860. doi: 10.1111/hel.12860. Epub 2021 Oct 27.
Although the association between the eradication of Helicobacter pylori (H. pylori) and smoking has been confirmed through a meta-analysis, many new studies have reported inconsistent conclusions. An up-to-date meta-analysis based on published relevant studies was conducted in this study to address this issue.
Eligible studies up to January 2021 were screened and retrieved using PubMed and Web of Science as well as by performing a manual review of references. We calculated the pooled odd ratios (OR) with the 95% confidence interval (CI). Subgroup and sensitivity analyses were also performed. Begg's test was used to determine the publication bias.
In total, 39 studies were included in the meta-analysis. The results showed that smoking increases the failure rate of H. pylori eradication treatment (OR = 1.70, 95%CI, 1.49-1.93). The risk of failure also increases with an increase in the smoking dose (>5 cigarettes per day) (OR = 2.59, 95%CI, 1.28-5.24) and the current smoking status (continued to smoke during treatment) (OR = 2.49, 95%CI, 1.52-4.06). Studies with a large proportion of patients with peptic ulcer (OR = 2.14, 95%CI, 1.51-3.02) revealed a higher failure rate among smokers than those with a low proportion of patients with peptic ulcer (OR = 1.57, 95%CI, 1.36-1.81). When vonoprazan (VPZ) was used to treat H. pylori infection, smoking did not affect the eradication rate (OR = 0.94, 95%CI, 0.51-1.75).
Smoking increases the failure rate of H. pylori eradication treatment. The risk of H. pylori eradication failure in smokers increases with a current smoking status and a high smoking dose. However, when VPZ is used to treat the H. pylori infection, smoking has no effect on the eradication rate.
虽然荟萃分析已经证实了幽门螺杆菌（H. pylori）根除与吸烟之间的关联，但许多新的研究报告得出了不一致的结论。本研究基于已发表的相关研究进行了最新的荟萃分析，以解决这一问题。
筛选并检索了截至 2021 年 1 月的符合条件的研究，使用 PubMed 和 Web of Science 以及手动查阅参考文献进行检索。我们计算了合并的比值比（OR）及其 95%置信区间（CI）。还进行了亚组和敏感性分析。Begg 检验用于确定发表偏倚。
共有 39 项研究纳入荟萃分析。结果表明，吸烟会增加 H. pylori 根除治疗失败的风险（OR=1.70，95%CI，1.49-1.93）。随着吸烟剂量的增加（每天>5 支香烟）（OR=2.59，95%CI，1.28-5.24）和当前吸烟状态（治疗期间持续吸烟）（OR=2.49，95%CI，1.52-4.06），失败的风险也会增加。在有大量消化性溃疡患者的研究中（OR=2.14，95%CI，1.51-3.02），吸烟者的治疗失败率高于消化性溃疡患者比例较低的研究（OR=1.57，95%CI，1.36-1.81）。当使用 vonoprazan（VPZ）治疗 H. pylori 感染时，吸烟不会影响根除率（OR=0.94，95%CI，0.51-1.75）。
吸烟会增加 H. pylori 根除治疗的失败率。吸烟者的 H. pylori 根除治疗失败风险随着当前吸烟状态和高吸烟剂量的增加而增加。然而，当使用 VPZ 治疗 H. pylori 感染时，吸烟对根除率没有影响。
