幽门螺杆菌高毒力株感染与动脉粥样硬化性脑梗死发病风险的Meta分析

目的评估幽门螺杆菌（Hp）细胞毒素相关蛋白A（CagA）血清抗体阳性菌株（以下简称CagA阳性株）感染与动脉粥样硬化性脑梗死（ACI）发病风险的相关性。方法通过文献检索收集相关文献，按统一的纳入和排除标准获取文献，应用RevMan 4.2软件对纳入文献进行Meta分析。结果共检索到10篇符合纳入标准的文献，均为病例对照研究。病例组共纳入研究对象907例，对照组共纳入966例；将纳入人群分为中国人群和欧洲高加索人群进行亚组分析。CagA阳性株感染与ACI发病风险Meta分析结果显示，总体人群OR为2.66（2.17~3.26）、中国人群亚组OR为2.60（1.93~3.49）、欧洲高加索人群亚组OR为2.71（2.05~3.59）；CagA血清抗体阴性Hp感染与ACI发病风险Meta分析结果显示，总体人群OR为0.74（0.49~1.10）、中国人群亚组OR为0.81（0.45~1.48）、欧洲高加索人群亚组OR为0.64（0.37~1.09）。漏斗图及失效安全数法提示未见明显发表偏倚，结果稳定可靠。结论CagA阳性株慢性感染可能是ACI动脉粥样硬化性脑梗死发病危险因素之一，但CagA阳性株根除性治疗是否会影响ACI等动脉粥样硬化性疾病的发病过程，有待进一步研究证实。

Meta analysis on the relationship between virulent strains of Helicobacter pylori and risk of atherosclerotic cerebral infarction

Objective To evaluate the relationship between cytotoxin-associated gene-A（CagA）seropositive of Helicobacter pylori（H.pylori）infection and risk of atherosclerotic cerebral infarction（ACI）.Methods Related literatures were researched through literature retrieval,literatures were obtained by uniformed criteria of inclusion and exclusion,and Meta analysis was performed with RevMan 4.2 software.Results A total of 10 literatures which met the inclusion criteria were retrieved,all were case-control study,case group included907 studied subjects,and control group included 966 subjects;the included population were divided into Chinese subgroup and European Caucasian subgroup.Meta analysis of CagA seropositive of H.pylori infection and risk of ACI revealed that ORof the overall population,Chinese subgroup,and European Caucasian subgroup was 2.66（2.17-3.26）,2.60（1.93-3.49）,and2.71（2.05-3.59）respectively;Meta analysis of CagA seronegative of H.pylori infection and risk of ACI revealed that ORof the overall population,Chinese subgroup,and European Caucasian subgroup was 0.74（0.49-1.10）,0.81（0.45-1.48）,and0.64（0.37-1.09）respectively.The funnel plot and fail-safe number showed that there was no significant publication bias,the result was stable and reliable.Conclusion Chronic infection caused by CagA seropositive strains of H.pylori may be one of the risk factors of CAI,whether the eradication treatment of seropositive strains of H.pylori influences the process of atherosclerotic diseases like CAI needs to be further studied.