冠心病患者幽门螺旋杆菌感染与血同型半胱氨酸浓度相关性的Meta分析
Relationship between Helicobacter Pylori Infection and Serum Concentration of Homocysteine in Patients with Coronary Heart Disease by Meta-Analysis
王凤华 1魏茂提 1孙佳禾2
作者信息
- 1. 中国医学科学院 北京协和医学院 泰达国际心血管病医院 临床流行病学中心,天津 300457
- 2. 中国医学科学院 北京协和医学院 泰达国际心血管病医院 心内科,天津 300457
- 折叠
摘要
目的 探讨冠状动脉粥样硬化性心脏病(冠心病)患者幽门螺旋杆菌(Helicobacter pylori,H.pylori)感染与血同型半胱氨酸(homocysteine,Hcy)浓度的关系.方法 检索Pubmed、Embase、Cochrane图书馆、中国知网、维普及万方数据库,搜集国内外已经公开发表的关于冠心病患者H.pylori感染与Hcy浓度相关性的研究.由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,利用Stata14.0软件进行综合分析.结果 经检索和筛选,共纳入9篇文献.其中,1项研究来自日本,1项来自土耳其,1项来自英国,其余均来自中国.纳入研究的纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale,NOS)质量评分均≥7 分.共入选患者 1 676 例,包括1 073例H.pylori阳性者和603例H.pylori阴性者.Meta分析结果显示,冠心病患者中H.pylori阳性者的Hcy浓度高于H.pylori阴性者[标准化均数差值(standard mean difference,SMD)=0.91,95%可信区间(confidence interval,CI):0.46～1.35,P<0.01].亚组分析显示,在≥60岁和<60岁的研究中,H.pylori感染阳性者的Hcy浓度均高于H.pylori阴性者(<60岁:SMD=0.93,95%CI:0.32～1.54,P<0.01;≥60岁:SMD=0.44,95%CI:0.09～0.79,P=0.01).使用13-C或14-C尿素呼气试验与使用酶联免疫吸附测定法(enzyme-linked immunosorbent assay,ELISA)判断H.pylori感染的研究中,H.pylori感染阳性者的Hcy浓度均高于H.pylori阴性者(尿素呼气试验:SMD=1.16,95%CI:0.59～1.73,P<0.05;ELISA:SMD=0.58,95%CI:-0.02～1.18,P=0.06).结论 冠心病患者H.pylori感染对血清Hcy浓度有影响,阳性感染者Hcy浓度显著升高.
Abstract
Objectives To investigate the relationship between Helicobacter pylori(H.pylori)infection and serum concentration of Homocysteine(Hcy)in patients with coronary heart disease.Methods We searched the databases of Pubmed,Embase,Cochrane Library,CNKI,and Wanfang to collect the published studies on the relationship between H.ylori infection and serum concentration of Hcy in patients with coronary heart disease.After literature screening,data extraction and bias risk evaluation were conducted independently by two researchers.Stata14.0 software was used for com-prehensive analysis.Results After searching and screening,a total of 9 literatures including 1 study from Japan,1 study from Turkey,1 study from the United Kingdom,and the others from China were included.All Newcastle-Ottawa Scale(NOS)quality scores included in the study were≥7 points.A total of 1 676 cases including 1 073 H.pylori positive and 603 H.Pylori negative were collected.Meta-analysis showed that H.pylori-positive patients with coronary heart disease had higher concentrations of Hcy than H.pylori-negative patients[standardized mean difference(SMD)=0.91,95%confidence interval(CI):0.46-1.35,P<0.01].Subgroup analysis showed that in both≥60 years and<60 years patients,concentrations of Hcy were higher in positive H.pylori patients than in negative H.Pylori patients(<60 years:SMD=0.93,95%CI:0.32-1.54,P<0.01;≥60 years old:SMD=0.44,95%CI:0.09-0.79,P=0.01).In both the 13-C and 14-C urea breath test and the enzyme-linked immunosorbent assay(ELISA)studies for H.Pylori infection,concentrations of Hcy in positive H.Pylori patients were higher than those in negative H.Pylori patients(urea breath test:SMD=1.16,95%CI:0.59-1.73,P<0.05;ELISA:SMD=0.58,95%CI:-0.02～1.18,P=0.06).Conclusions H.pylori infection in patients with coronary heart disease has an effect on serum concentration of Hcy,and the concentration of Hcy in positive patients is significantly increased.
关键词
冠状动脉疾病/幽门螺旋杆菌/Hcy/Meta分析Key words
coronary heart disease/Helicobacter pylori/homocysteine/meta-analysis引用本文复制引用
出版年
2024
NETL
NSTL
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