南方医科大学学报

南方医科大学学报 ›› 2013, Vol. 33 ›› Issue (05): 719-.

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根治幽门螺旋杆菌可诱发胃食管反流病：多个随机对照研究的Meta分析

谢婷婷，郑浩轩，姜泊   

  • 出版日期:2013-05-20 发布日期:2013-05-20

Eradication of H.pylori may cause gastroesophageal reflux disease: a meta-analysis

  • Online:2013-05-20 Published:2013-05-20

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摘要： 目的通过对中外多篇随机对照研究的Meta分析，评价根治幽门螺旋杆菌（H. pylori）是否会诱发胃食管反流病（GERD）。
方法通过对多个医学数据库的检索，搜集2000~2012 年国内外公开发表的对比根治与非根治H. pylori 后GERD发生、发展
的随机对照研究进行Meta分析，同时根据地域性分成欧美组与亚洲组，同时根据随访时间<12月及≥12月进行亚组分析。结
果最终符合标准的纳入文献16篇，合并统计相对危险度：1.89，95% CI：1.50~2.40），提示根治H. pylori可能诱发GERD。结论
H. pylori是GERD的保护因素之一，在亚洲人群及长时间随访人群中更为显著，根治H. pylori可诱发GERD。

Abstract: Objective To confirm whether eradication of H. pylori is associated with the occurrence of gastroesophageal reflux
disease (GERD). Methods We searched multiple medical databases for published randomized controlled trials (RCTs) from
2000 to 2012 comparing the incidence of GERD in adult patients receiving H. pylori treatment and those without treatment. The
effects of H. pylori eradication were analyzed by calculating the pooled estimates for the number of new cases of GERD. Each
racial subgroup of patients was analyzed using risk ratio (RR) by fixed effects models. The publication bias was assessed with
funnel plot, Egger and Begg’s test. Results Sixteen eligible RCTs were finally included in the analysis. Statistically analysis
suggested H. pylori eradication was significantly correlated with the occurrence of GERD (RR 1.89, 95% CI 1.50-2.40). Funnel
plot, Egger or Begg’s test revealed no publication bias. Conclusion H. pylori may have a positive effect on GERD especially in
Asian patients and those with long-term follow-up, and eradication of H. pylori may cause GERD.