抗生素是否会导致炎症性肠病? 一个系统的审查和元分析
Ellen Scharf1, Peter Schlattmann2, Johannes Stallhofer1
1Department of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Jena, Germany.
以前使用抗生素会增加患炎症性肠病 (IBD),特别是克罗恩病 (CD) 的风险. 这种风险随着抗生素疗程数量的增加而增加,突出显示了合理的抗生素处方的必要性.
科学领域:
- 胃肠病学 胃肠病学
- 微生物学 微生物学
- 流行病学 流行病学
背景情况:
- 炎症性肠病 (IBD),包括克罗恩病 (CD) 和性结肠炎 (UC),具有复杂的原因,涉及遗传学和环境.
- 抗生素的使用可能会改变肠道微生物群,可能会增加IBD风险,但证据仍然不确.
研究的目的:
- 进行一项元分析,评估先前的抗生素暴露与IBD发病之间的关联.
- 为了调查这种关联是否在CD和UC之间有所不同.
- 探索抗生素疗程和IBD风险之间的潜在剂量反应关系.
主要方法:
- 使用PubMed进行了系统的文献搜索,以确定相关的研究.
- 按照PRISMA指南进行的元分析被用于组合风险估计 (odds比率和置信区间).
- 亚组分析检查了不同类型的抗生素和治疗疗程的数量.
主要成果:
- 分析包括31项研究,共有102,103名参与者.
- 以前的抗生素暴露与IBD风险增加40%有关 (OR:1.40).
- 这种关联对于克罗恩病 (OR: 1.50) 是显著的,但对于性结肠炎 (OR: 1.21) 则不是显著的. 随着抗生素疗程的增加,观察到一种积极的剂量反应关系.
结论:
- 以前使用抗生素与患克罗恩病的风险增加有关.
- 剂量反应效应表明,更多的抗生素疗程与更高的IBD风险相关.
- 建议合理管理抗生素,以减轻潜在的风险.
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