缺铁性贫血合并幽门螺杆菌感染治疗效果的Meta分析
|
摘要
目的评价补充铁剂联合根除幽门螺杆菌(Hp)治疗(联合治疗)对缺铁性贫血合并Hp感染患者的效果。方法检索中国学术期刊网络出版总库、维普中文科技期刊数据库、万方中国学术期刊数据库、PubMed、Embase和Cochrane Library等中英文数据库,查找关于联合治疗与单用铁剂治疗对缺铁性贫血合并Hp感染患者效果比较的文献,发表时间为2000—2018年。采用均数差(WMD)或标准化均数差(SMD)评估治疗前后血红蛋白、血清铁和铁蛋白指标变化。结果搜索到1 908篇文献,最终纳入12篇随机对照试验(RCT)研究文献,包括790例缺铁性贫血合并Hp感染患者,联合治疗组和单用铁剂治疗组各395例。联合治疗组患者治疗后血红蛋白水平(WMD=13.38,95%CI:9.40～17.37)、血清铁水平(WMD=5.31,95%CI:3.92～6.69)和铁蛋白水平(SMD=1.84,95%CI:1.01～2.67)均高于单用铁剂治疗组。结论对于缺铁性贫血合并Hp感染患者,补充铁剂联合根除Hp治疗效果明显优于单用铁剂治疗。
引文
[1] PASRICHA S R,COLMAN K,CENTENO-TABLANTE E,et al.Revisiting WHO haemoglobin thresholds to define anaemia in clinical medicine and public health[J]. The Lancet Haematology,2018,5(2):60-62.
[2]周潇潇,王子睿,陈庚,等.台州市中小学生贫血监测结果分析[J].预防医学,2018,30(2):208-210.
[3] FLORES S E,AITCHISON A,DAY A S,et al. Helicobacter pylori infection perturbs iron homeostasis in gastric epithelial cells[J].PLo S One,2017,12(9):e0184026.
[4] RAZUKA-EBELA D,GIUPPONI B,FRANCESCHI F,et al. Helicobacter pylori and extragastric diseases[J]. Helicobacter,2018,23(S1):12520.
[5]马红英,吕春兰.怀柔区健康体检人群幽门螺杆菌感染调查[J].预防医学,2018,30(7):711-712,716.
[6]何烁,姜双英.江山市学龄前儿童幽门螺杆菌感染及影响因素调查[J].预防医学,2016,28(12):1274-1276.
[7] HUDAK L,JARAISY A,HAJ S,et al. An updated systematic review and meta-analysis on the association between Helicobacter pylori infection and iron deficiency anemia[J]. Helicobacter,2017,22(1):12330.
[8] JADAD A R,MOORE R A,CARROLL D,et al. Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J]. Controlled clinical trials,1996,17(1):1-12.
[9] POWERS J M, BUCHANAN G R, ADIX L, et al. Effect of low-dose ferrous sulfate vs iron polysaccharide complex on hemoglobin concentration in young children with nutritional iron-deficiency anemia:a randomized clinical trial[J]. JAMA,2017, 317(22):2297-2304.
[10] CHEN L H,LUO H S. Effects of H pylori therapy on erythrocytic and iron parameters in iron deficiency anemia patients with H pylori-positive chronic gastristis[J]. World J Gastroentero,2007,13(40):5380-5383.
[11] GESSNER B D,BAGGETT H C,MUTH P T,et al. A controlled,household-randomized,open-label trial of the effect that treatment of Helicobacter pylori infection has on iron deficiency in children in rural Alaska[J]. J Infect Dis,2006,193(4):537-546.
[12] VIJAYAN G,SUNDARAM R C,BOBBY Z,et al. Increased plasma malondialdehyde and fructosamine in anemic H pylori infected patients:effect of treatment[J]. World J Gastroentero,2007,13(5):796-800.
[13] XIA W,ZHANG X,WANG J,et al. Survey of anaemia and Helicobacter pylori infection in adolescent girls in Suihua, China and enhancement of iron intervention effects by H. pylori eradication[J]. Brit J Nutr,2012,108(2):357-362.
[14]管业伟,李秀珍.幽门螺杆菌感染与缺铁性贫血的关系[J].广东医学,2002,23(12):1262-1263.
[15]黄烈平,庄满利,贝国平,等.幽门螺杆菌感染相关性缺铁性贫血的治疗[J].实用儿科临床杂志,2005,20(1):30-31.
[16]黄正国,邵成良.小儿缺铁性贫血伴幽门螺杆菌感染治疗的前瞻性研究[J].现代中西医结合杂志,2007,16(22):3163-3164.
[17]李秀珍,管业伟.抗幽门螺杆菌感染在缺铁性贫血中的意义[J].中国校医,2003,17(3):227-228.
[18]林英,王伟光,王淑珍.缺铁性贫血伴幽门螺杆菌感染68例的治疗[J].中国当代儿科杂志,2005,7(5):429-431.
[19]王秉慧,冷明芳,周丽群,等.小儿幽门螺杆菌感染与缺铁性贫血的临床研究[J].临床儿科杂志,2006,24(10):815-817.
[20]王建国,徐宛玲,王凤枝,等.青少年幽门螺杆菌相关性缺铁性贫血临床研究[J].医学理论与实践,2005,18(9):1007-1009.
[21]郑洁,郭军.幽门螺杆菌感染与缺铁性贫血关系的临床研究[J].现代医药卫生,2007,23(23):3503-3504.
[22]刘文忠,谢勇,陆红,等.第五次全国幽门螺杆菌感染处理共识报告[J].胃肠病学,2017,22(6):346-360.
[23] JOHN S,BALTODANO J D,MEHTA N,et al. Unexplained iron deficiency anemia:does Helicobacter pylori have a role to play?[J]. Gastroenterol Rep,2018,6(3):215-220.
[24] GISBERT J P,GRAHAM D Y,ROKKAS T,et al. Management of Helicobacter pylori infection—the Maastricht IV/Florence Consensus Report[J]. Gut,2012,61(5):646-664.
[25]范小红,孟亚红,王雪莲,等.静脉铁剂治疗重度缺铁性贫血患者的铁代谢变化特点[J].临床血液学杂志,2018,31(5):40-43.
[2]周潇潇,王子睿,陈庚,等.台州市中小学生贫血监测结果分析[J].预防医学,2018,30(2):208-210.
[3] FLORES S E,AITCHISON A,DAY A S,et al. Helicobacter pylori infection perturbs iron homeostasis in gastric epithelial cells[J].PLo S One,2017,12(9):e0184026.
[4] RAZUKA-EBELA D,GIUPPONI B,FRANCESCHI F,et al. Helicobacter pylori and extragastric diseases[J]. Helicobacter,2018,23(S1):12520.
[5]马红英,吕春兰.怀柔区健康体检人群幽门螺杆菌感染调查[J].预防医学,2018,30(7):711-712,716.
[6]何烁,姜双英.江山市学龄前儿童幽门螺杆菌感染及影响因素调查[J].预防医学,2016,28(12):1274-1276.
[7] HUDAK L,JARAISY A,HAJ S,et al. An updated systematic review and meta-analysis on the association between Helicobacter pylori infection and iron deficiency anemia[J]. Helicobacter,2017,22(1):12330.
[8] JADAD A R,MOORE R A,CARROLL D,et al. Assessing the quality of reports of randomized clinical trials:is blinding necessary?[J]. Controlled clinical trials,1996,17(1):1-12.
[9] POWERS J M, BUCHANAN G R, ADIX L, et al. Effect of low-dose ferrous sulfate vs iron polysaccharide complex on hemoglobin concentration in young children with nutritional iron-deficiency anemia:a randomized clinical trial[J]. JAMA,2017, 317(22):2297-2304.
[10] CHEN L H,LUO H S. Effects of H pylori therapy on erythrocytic and iron parameters in iron deficiency anemia patients with H pylori-positive chronic gastristis[J]. World J Gastroentero,2007,13(40):5380-5383.
[11] GESSNER B D,BAGGETT H C,MUTH P T,et al. A controlled,household-randomized,open-label trial of the effect that treatment of Helicobacter pylori infection has on iron deficiency in children in rural Alaska[J]. J Infect Dis,2006,193(4):537-546.
[12] VIJAYAN G,SUNDARAM R C,BOBBY Z,et al. Increased plasma malondialdehyde and fructosamine in anemic H pylori infected patients:effect of treatment[J]. World J Gastroentero,2007,13(5):796-800.
[13] XIA W,ZHANG X,WANG J,et al. Survey of anaemia and Helicobacter pylori infection in adolescent girls in Suihua, China and enhancement of iron intervention effects by H. pylori eradication[J]. Brit J Nutr,2012,108(2):357-362.
[14]管业伟,李秀珍.幽门螺杆菌感染与缺铁性贫血的关系[J].广东医学,2002,23(12):1262-1263.
[15]黄烈平,庄满利,贝国平,等.幽门螺杆菌感染相关性缺铁性贫血的治疗[J].实用儿科临床杂志,2005,20(1):30-31.
[16]黄正国,邵成良.小儿缺铁性贫血伴幽门螺杆菌感染治疗的前瞻性研究[J].现代中西医结合杂志,2007,16(22):3163-3164.
[17]李秀珍,管业伟.抗幽门螺杆菌感染在缺铁性贫血中的意义[J].中国校医,2003,17(3):227-228.
[18]林英,王伟光,王淑珍.缺铁性贫血伴幽门螺杆菌感染68例的治疗[J].中国当代儿科杂志,2005,7(5):429-431.
[19]王秉慧,冷明芳,周丽群,等.小儿幽门螺杆菌感染与缺铁性贫血的临床研究[J].临床儿科杂志,2006,24(10):815-817.
[20]王建国,徐宛玲,王凤枝,等.青少年幽门螺杆菌相关性缺铁性贫血临床研究[J].医学理论与实践,2005,18(9):1007-1009.
[21]郑洁,郭军.幽门螺杆菌感染与缺铁性贫血关系的临床研究[J].现代医药卫生,2007,23(23):3503-3504.
[22]刘文忠,谢勇,陆红,等.第五次全国幽门螺杆菌感染处理共识报告[J].胃肠病学,2017,22(6):346-360.
[23] JOHN S,BALTODANO J D,MEHTA N,et al. Unexplained iron deficiency anemia:does Helicobacter pylori have a role to play?[J]. Gastroenterol Rep,2018,6(3):215-220.
[24] GISBERT J P,GRAHAM D Y,ROKKAS T,et al. Management of Helicobacter pylori infection—the Maastricht IV/Florence Consensus Report[J]. Gut,2012,61(5):646-664.
[25]范小红,孟亚红,王雪莲,等.静脉铁剂治疗重度缺铁性贫血患者的铁代谢变化特点[J].临床血液学杂志,2018,31(5):40-43.