杆菌感染与乙性食道炎之间的关联:系统性审查和元分析
Lucía Gutiérrez-Ramírez1,2, Sandra L Garcia-Dionisio1,3, Sara Feo-Ortega4
1Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Toledo, Spain.
杆菌 (H. pylori) 感染可能会降低患有异性食道炎 (EoE) 的风险. 然而,这种关联是基于低确定性证据,主要来自具有偏差高风险的研究.
科学领域:
- 胃肠病学 胃肠病学
- 流行病学 流行病学
- 微生物学 微生物学
背景情况:
- 螺旋杆菌 (H. pylori) 感染与患有埃索诺菲尔性食道炎 (EoE) 的几率降低有关.
- 杆菌对EoE的潜在保护作用需要进一步研究.
研究的目的:
- 系统地审查和分析有关H. pylori感染和EoE之间关联的流行病学研究.
- 量化这种关联的强度,并评估证据的确定性.
主要方法:
- 在MEDLINE/PUBMED,EMBASE和SCOPUS数据库中进行了全面的文献搜索.
- 包括16项观察性研究,涉及30,650名患者和291,908名对照.
- 使用ROBINS-E评估了偏差风险,并通过随机效应元分析与GRADE确定性评估汇总了数据.
主要成果:
- 根据低确定性证据,H. pylori暴露与EoE的几率显著降低有关 (OR0.56;95% CI,0.46-0.70).
- 保护作用在病例控制和回顾性研究中更为明显,特别是那些具有高偏差风险的研究.
- 在前性研究或具有中度至低偏差风险的研究中没有发现显著的关联.
结论:
- 观察到的H. pylori和减少EoE风险之间的关联在很大程度上是由具有高偏差的回顾性研究驱动的.
- 需要进一步的高质量,精心设计的流行病学研究来证实或反驳这种关联.
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