【摘要】：目的:探討人群中幽門螺桿菌(Hp)感染與結(jié)直腸息肉發(fā)病之間的相關(guān)性。并探討不同Hp檢測方法、息肉病理類型、人群地域差異等對Hp感染與結(jié)直腸息肉發(fā)病相關(guān)性的影響。方法:在線檢索:MEDLINE、PUBMED、EMBASE和Science Direct數(shù)據(jù)庫,收集從建庫至2016年3月關(guān)于Hp感染與結(jié)直腸息肉發(fā)病關(guān)系的文獻。應(yīng)用RevMan 5.3軟件對符合納入標(biāo)準(zhǔn)的文獻進行Meta分析。結(jié)果:共納入18項研究,總樣本量為136126例,其中結(jié)直腸息肉72462例,健康對照63664例;結(jié)直腸息肉組Hp(+)13193例,健康對照組Hp(+)11452例。Meta分析結(jié)果顯示結(jié)直腸息肉組和健康對照組Hp感染率差異有統(tǒng)計學(xué)意義,OR=1.42(95%CI:1.24-1.62,P0.01)。敏感分析提示研究結(jié)果較穩(wěn)健。發(fā)表偏倚檢測未發(fā)現(xiàn)明顯發(fā)表偏倚存在�；贖p不同檢測方法亞組分析顯示,Hp感染與結(jié)直腸息肉發(fā)病相關(guān)性不受Hp檢測方法影響,血清學(xué)檢測:OR=1.64(95%CI:1.43-1.88,P0.01),非血清檢測:OR=1.40(95%CI:1.36-1.45,P0.01)。息肉病理類型亞組分析顯示,Hp感染與非腫瘤性息肉發(fā)病相關(guān)性無統(tǒng)計學(xué)意義,OR=1.04(95%CI:0.72-1.48,P=0.84),而與腫瘤性息肉發(fā)病相關(guān)性具有統(tǒng)計學(xué)意義,OR=1.47(95%CI:1.31-1.64,P0.01)。在人群地域差異亞組分析中顯示,不同地域人群中Hp感染與結(jié)直腸息肉發(fā)病相關(guān)性均具有統(tǒng)計學(xué)意義,歐洲:OR=2.00(95%CI:1.49-2.67,P0.01),亞洲:OR=1.42(95%CI:1.31-1.54,P0.01),美洲:OR=1.41(95%CI:1.36-1.46,P0.01)。結(jié)論:Hp感染是結(jié)直腸息肉發(fā)病的危險因素,其感染與結(jié)直腸息肉發(fā)病相關(guān),尤其與結(jié)直腸腫瘤性息肉發(fā)病相關(guān),相關(guān)性不受Hp檢測方法及人群地域不同的影響。
[Abstract]:Objective: to investigate the correlation between Helicobacter pylori (Hp) infection and colorectal polyps. The effects of different HP detection methods, pathological types of polyps and population regional differences on the relationship between HP infection and colorectal polyps were discussed. Methods: the databases of Science Direct and PUBMEDASE were searched online, and the literatures on the relationship between HP infection and colorectal polyps were collected from the establishment of the library to March 2016. RevMan 5.3 software was used for Meta analysis of the literature in accordance with the inclusion criteria. Results: the total sample size was 136126 cases, including 72462 cases of colorectal polyps and 63664 cases of healthy controls, 13193 cases of Hp () in colorectal polyps group, 13193 cases in colorectal polyps group and 13193 cases in healthy controls. Meta-analysis of 11452 cases of Hp () in healthy control group showed that there was significant difference in HP infection rate between colorectal polyp group and healthy control group (95 CI: 1.24-1.62p0.01). Sensitivity analysis indicated that the results of the study were more robust. No obvious publication bias was found in the publication bias test. The subgroup analysis based on different HP detection methods showed that the correlation between HP infection and colorectal polyps was not affected by HP detection method. The serological test was 1. 64 (95 CI: 1. 43-1. 8% P0.01), and the non serum detection was 1. 40 (95 CI: 1. 36-1. 45% P0.01). There was no significant correlation between HP infection and non-tumor polyps (95CI: 0.72-1.48P 0.84), but there was a significant correlation between HP infection and tumor polyps (95CI: 1.31-1.64P 0.01). In the subgroup analysis of population regional differences, the correlation between H.pylori infection and colorectal polyps was statistically significant in different population groups: Europe: 2.00 (95CI: 1.49-2.67 P0.01), Asia: 1.42 (95CI: 1.31-1.54P0.01), America: OR1.41 (95CI: 1.36-1.46P0.01). Conclusion the infection of HP is a risk factor for colorectal polyps. The infection is associated with colorectal polyps, especially colorectal tumor polyps, and the correlation is not affected by HP detection methods and different population regions.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.34

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