中国儿童及青少年幽门螺杆菌感染流行病学调查的系统评价和meta分析  

Systematic review and meta-analysis of epidemiological investigation of Helicobacter pylori infection in children and adolescents in China

作　　者：李兴川 王海东[3] 张妮[3] 王玉平 周永宁[1,2] LI Xingchuan;WANG Haidong;ZHANG Ni;WANG Yuping;ZHOU Yongning(The First Clinical Medical College of Lanzhou University, Lanzhou 730000, Gansu, China;Key Laboratory for Gastrointestinal Diseases of Gansu Province, Lanzhou 730000, Gansu, China;The Second Hospital of Lanzhou University, Lanzhou 730030,Gansu, China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]甘肃省胃肠病重点实验室,甘肃兰州730000 [3]兰州大学第二医院,甘肃兰州730030

出　　处：《临床儿科杂志》2017年第10期782-787,共6页Journal of Clinical Pediatrics

基　　金：国家自然科学基金面上项目(No.81372145);兰州大学中央高校基本科研业务费专项资金(No.lzujbky-2013-157);兰州大学第一医院院内基金(No.ldyyynqn201203)

摘　　要：目的系统评价中国儿童及青少年幽门螺杆菌(H.pylori)感染的流行病学特征。方法检索Pub Med、EMBASE、Cochrane图书馆、中国知网、万方数据库,检索起止时间为建库至2016年9月。2名研究者根据纳入与排除标准筛选文献,采用AHRQ量表评估文献质量,使用Stata 12.0软件进行meta分析。结果 7篇文献纳入meta分析,涉及16 950名儿童及青少年。中国自然人群儿童及青少年H.pylori总感染率为29%(95%CI:0.18~0.40);儿童及青少年H.pylori感染呈显著的地域分布性差异,在胃癌低发区,中国自然人群儿童H.pylori总感染率为20%(95%CI:0.13~0.28),在胃癌高发区H.pylori总感染率高达55%(95%CI:0.21~0.89);男性与女性H.pylori感染率无显著差异;≤1岁、~5岁、~10岁、~15岁、~18岁儿童及青少年的H.pylori感染率分别为17.8%、8%、19%、26%、45%,随年龄增长H.pylori感染率有上升趋势;农村儿童及青少年H.pylori感染风险是城市的1.25倍;有消化道症状的农村儿童及青少年H.pylori感染风险比无消化道症状者高2.2倍。结论中国自然人群儿童及青少年H.pylori总感染率为29%,呈现显著的地域分布性差异,胃癌高发区H.pylori感染率是胃癌低发区的2.8倍。仍需后续高质量、大样本量流行病学调查,以进一步明确中国儿童及青少年H.pylori感染情况。Objective To systematically evaluate the epidemiological characteristics of Helicobacter pylori(H.pylori)infection in children and adolescents in China.Methods PubMed,EMBASE,Cochrane library,CNKI,and Wanfang database were searched from the initial build of the database to September2016.Two researchers screened the literature based on the inclusion and exclusion criteria.The quality of the literatures was assessed by the AHRQ scale.The meta-analysis was performed by Stata12.0software.Results Seven articles with16950children and adolescents were included in the meta-analysis,.The total H.pylori infection rate in children and adolescents in China was29%(95%CI:0.18~0.40).The geographical distribution of H.pylori infection was significantly different.In the area with low incidence of gastric cancer,the total H.pylori infection rate in children and adolescents in China was20%(95%CI:0.13,0.28),in the area with high incidence of gastric cancer,the total H.pylori infection rate was55%(95%CI:0.21-0.89).The H.pylori infection rate was not significantly different between male and female.The H.pylori infection rates in children aged≤1year,~5years,~10years,~15years,~18years were17.8%,8%,19%,26%,45%respectively,which indicate a trend of rising with the age.The risk of H.pylori infection in rural children and adolescents is1.25times higher than that in urban.The rural children and adolescents with digestive symptoms are2.2times more likely to have H.pylori infection than those without digestive symptoms.Conclusions The total infection rate of H.pylori in Chinese children and adolescents is29%and there is significant difference in geographical distribution.The infection rate of H.pylori in the higher incidence area of gastric cancer is2.8times higher than that in the low incidence area of gastric cancer.However,high quality epidemiological investigation with large sample size is needed,in order to further clarify the details of H.pylori infection in children and adolescents in China.

关 键 词：幽门螺杆菌 流行病学 系统评价 META分析 儿童青少年 

分 类 号：R725.7[医药卫生—儿科]