School of Stomatology, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China.
Department of General Dentistry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310052, Zhejiang Province, China.
Clin Oral Investig. 2023 Nov;27(11):6345-6356. doi: 10.1007/s00784-023-05273-y. Epub 2023 Oct 6.
This meta-analysis was designed to provide new insights into the relationship between Helicobacter pylori (H. pylori) infection and recurrent aphthous stomatitis (RAS).
We included and evaluated studies on H. pylori infection and RAS from PubMed, EMBASE, Cochrane Library, and Web of Science databases published up to January 31, 2023. The characteristics of these studies were collected, and the quality was evaluated by Newcastle-Ottawa Scale (NOS). The random effects model was used to calculate the pooled odds ratio (OR) and 95% confidence interval (CI). To further explore the sources of heterogeneity, meta-regression analysis and subgroup analyses were performed. Funnel plot, Egger's test, and Begg's test were used to assess publication bias.
In total, fifteen case-control studies with 1137 individuals (601 cases and 536 controls) were included. The H. pylori was found to be significantly associated with RAS (OR: 1.83 95% CI: 1.41-2.37, P = 0.001). In the subgroup analyses, studies that used PCR (OR: 2.03 95% CI: 1.31-3.15) or UBT (OR: 1.83 95% CI: 1.13-2.96) yielded a significant positive association, while a non-significant association (OR: 1.12 95% CI: 0.61-2.08) was found from studies that used ELISA method. Sensitivity analyses showed that the results were robust. No significant publication bias was found.
The current evidence does not rule out an association between H. pylori and RAS. The effect of H. pylori on RAS varies in detection methods and sources of sample. Large samples, multiple clinical studies, and improved methods are still needed to determine the exact effect of H. pylori on RAS.
H. pylori infection may be a risk factor for the pathogenesis of RAS.
本荟萃分析旨在为幽门螺杆菌（H. pylori）感染与复发性阿弗他口炎（RAS）之间的关系提供新的见解。
我们纳入并评估了截至 2023 年 1 月 31 日在 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 数据库中发表的关于 H. pylori 感染与 RAS 的研究。收集这些研究的特征，并使用纽卡斯尔-渥太华量表（NOS）进行质量评估。使用随机效应模型计算合并的优势比（OR）和 95%置信区间（CI）。为了进一步探讨异质性的来源，进行了荟萃回归分析和亚组分析。漏斗图、Egger 检验和 Begg 检验用于评估发表偏倚。
共纳入 15 项病例对照研究，涉及 1137 人（601 例病例和 536 例对照）。结果发现 H. pylori 与 RAS 显著相关（OR：1.83，95%CI：1.41-2.37，P=0.001）。在亚组分析中，使用 PCR（OR：2.03，95%CI：1.31-3.15）或 UBT（OR：1.83，95%CI：1.13-2.96）的研究得出了显著的阳性关联，而使用 ELISA 方法的研究则发现关联不显著（OR：1.12，95%CI：0.61-2.08）。敏感性分析表明结果稳健。未发现明显的发表偏倚。
目前的证据并不能排除 H. pylori 与 RAS 之间的关联。H. pylori 对 RAS 的影响因检测方法和样本来源而异。仍需要大样本、多临床研究和改进方法来确定 H. pylori 对 RAS 的确切影响。
H. pylori 感染可能是 RAS 发病机制的一个危险因素。
