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1676例,包括1073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。
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 1676 cases including 1073 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.
作者
王凤华
魏茂提
孙佳禾
WANG Fenghua;WEI Maoti;SUN Jiahe(Center of Clinical Epidemiology,TEDA International Cardiovascular Hospital,Tianjin 300457,China;Department of Cardiology,TEDA International Cardiovascular Hospital,Tianjin 300457,China)
出处
《岭南心血管病杂志》
CAS
2024年第3期243-249,共7页
South China Journal of Cardiovascular Diseases
