萎缩性胃炎和肠上皮化生在幽门螺杆菌根除后会逆转吗？
Do atrophic gastritis and intestinal metaplasia reverse after Helicobacter pylori eradication?
机构信息
Department of Gastroenterology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People's Republic of China.
Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Centre, Shenzhen, Guangdong, People's Republic of China.
出版信息
Helicobacter. 2024 Jan-Feb;29(1):e13042. doi: 10.1111/hel.13042. Epub 2023 Nov 29.
BACKGROUND
It's still controversial whether Helicobacter pylori (H. pylori) eradication can reverse atrophic gastritis (AG) and intestinal metaplasia (IM). Therefore, we performed a meta-analysis to estimate the effect of H. pylori eradication on AG and IM.
METHODS
We searched the PubMed, Web of Science and EMBASE datasets through April 2023 for epidemiological studies, which provided mean glandular atrophy (GA) or IM score before and after H. pylori eradication, or provided ORs, RRs or HRs and 95% CIs for the association of AG or IM with H. pylori eradication. Weighted mean difference (WMD) and pooled ORs and 95%CIs were used to estimate the effect of H. pylori eradication on AG and IM.
RESULTS
Twenty articles with a total of 5242 participants were included in this meta-analysis. H. pylori eradication significantly decreased GA score in the antrum (WMD -0.36; 95% CI: -0.52, -0.19, p < 0.01), GA score in the corpus (WMD -0.35; 95% CI: -0.52, -0.19, p < 0.01), IM score in the antrum (WMD -0.16; 95% CI: -0.26, -0.07, p < 0.01) and IM score in the corpus (WMD -0.20; 95% CI: -0.37, -0.04, p = 0.01). H. pylori eradication significantly improved AG (pooled OR 2.96; 95% CI: 1.70, 5.14, p < 0.01) and IM (pooled OR 2.41; 95% CI: 1.24, 4.70, p < 0.01). The association remained significant in the subgroup analyses by study design, sites of lesions, regions and follow-up time. Although Publication bias was observed for AG, the association remained significant after trim-and-fill adjustment.
CONCLUSIONS
H. pylori eradication could significantly improve AG and IM at early stage.
背景
幽门螺杆菌（H. pylori）根除是否能逆转萎缩性胃炎（AG）和肠上皮化生（IM）仍存在争议。因此，我们进行了一项荟萃分析，以评估 H. pylori 根除对 AG 和 IM 的影响。
方法
我们检索了 PubMed、Web of Science 和 EMBASE 数据库，截至 2023 年 4 月，以获取提供 H. pylori 根除前后腺体萎缩（GA）或 IM 评分的流行病学研究，或提供 AG 或 IM 与 H. pylori 根除之间关联的比值比（OR）、相对危险度（RR）或风险比（HR）和 95%置信区间（CI）。使用加权均数差（WMD）和汇总 OR 及其 95%CI 来估计 H. pylori 根除对 AG 和 IM 的影响。
结果
本荟萃分析纳入了 20 项研究，共计 5242 名参与者。H. pylori 根除显著降低了胃窦部的 GA 评分（WMD-0.36；95%CI：-0.52，-0.19，p<0.01）、胃体部的 GA 评分（WMD-0.35；95%CI：-0.52，-0.19，p<0.01）、胃窦部的 IM 评分（WMD-0.16；95%CI：-0.26，-0.07，p<0.01）和胃体部的 IM 评分（WMD-0.20；95%CI：-0.37，-0.04，p=0.01）。H. pylori 根除显著改善了 AG（汇总 OR 2.96；95%CI：1.70，5.14，p<0.01）和 IM（汇总 OR 2.41；95%CI：1.24，4.70，p<0.01）。在研究设计、病变部位、地区和随访时间的亚组分析中，该关联仍然显著。尽管 AG 存在发表偏倚，但在修剪和填充调整后，该关联仍然显著。
结论
H. pylori 根除可显著改善早期的 AG 和 IM。
Zotero 插件