Systematic review of time trends in the prevalence of Helicobacter pylori infection in China and the USA.
Systematic review of time trends in the prevalence of Helicobacter pylori infection in China and the USA.
复制标题
在中国和美国幽门螺杆菌感染流行的时间趋势的系统综述。
DOI：
10.1186/s13099-016-0091-7
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发表时间：
2016
期刊：
影响因子：
4.2
通讯作者：
Molloy-Bland M
中科院分区：
文献类型：
--
作者：
Nagy P;Johansson S;Molloy-Bland M
有研究表明，幽门螺杆菌感染的流行率在美国已经稳定，在中国正在下降。我们进行了系统的文献分析来验证这一假设。PubMed和Embase检索进行到2015年1月19日。使用Microsoft Excel进行回归分析，评估幽门螺杆菌感染率随时间的变化趋势。总体而言，纳入了25项中国研究（贡献28个数据集）和11项美国研究（贡献11个数据集）。随着时间的推移，中国研究的幽门螺杆菌感染患病率显著下降（p = 0.00018），当研究仅限于使用血清免疫球蛋白G （IgG）检测幽门螺杆菌感染时（p = 0.014； 20个数据集）。中国农村人口幽门螺杆菌感染的加权平均患病率为66%，城市人口为47%。在仅包括城市人群的研究中，幽门螺杆菌感染率呈显著下降趋势（p = 0.04； 9个数据集）。当这些研究进一步局限于那些使用血清IgG检测幽门螺杆菌感染的研究时，这一趋势不再具有统计学意义，尽管这可能是因为可用于该分析的数据集较少，统计能力较低（p = 0.28； 6个数据集）。在美国进行的研究中，幽门螺杆菌感染的流行率随时间的变化没有明显的趋势。总之，中国的幽门螺杆菌感染率极有可能下降，这是由于城市化程度的提高，我们发现这与较低的幽门螺杆菌感染率有关，也可能与城市人群中幽门螺杆菌感染率下降有关。随着时间的推移，这可能会导致中国消化性溃疡和胃癌发病率的逐渐下降。本文的在线版本（doi:10.1186/s13099-016-0091-7）包含补充材料，仅供授权用户使用。
It has been suggested that the prevalence of Helicobacter pylori infection has stabilized in the USA and is decreasing in China. We conducted a systematic literature analysis to test this hypothesis. PubMed and Embase searches were conducted up to 19 January 2015. Trends in the prevalence of H. pylori infection over time were assessed by regression analysis using Microsoft Excel. Overall, 25 Chinese studies (contributing 28 datasets) and 11 US studies (contributing 11 datasets) were included. There was a significant decrease over time in the H. pylori infection prevalence for the Chinese studies overall (p = 0.00018) and when studies were limited to those that used serum immunoglobulin G (IgG) assays to detect H. pylori infection (p = 0.014; 20 datasets). The weighted mean prevalence of H. pylori infection was 66 % for rural Chinese populations and 47 % for urban Chinese populations. There was a significant trend towards a decreasing prevalence of H. pylori infection for studies that included only urban populations (p = 0.04; 9 datasets). This trend was no longer statistically significant when these studies were further restricted to those that used serum IgG assays to detect H. pylori infection, although this may have been because of low statistical power due to the small number of datasets available for this analysis (p = 0.28; 6 datasets). There were no significant trends in terms of changes in the prevalence of H. pylori infection over time for studies conducted in the USA. In conclusion, the prevalence of H. pylori infection is most likely decreasing in China, due to a combination of increasing urbanization, which we found to be associated with lower H. pylori infection rates, and possibly also decreasing rates of H. pylori infection within urban populations. This will probably result in a gradual decrease in peptic ulcer and gastric cancer rates in China over time. The online version of this article (doi:10.1186/s13099-016-0091-7) contains supplementary material, which is available to authorized users.