尿路感染与原发性胆汁性胆管炎相关的meta分析

肝脏 ›› 2020, Vol. 25 ›› Issue (10): 1086-1089.

尿路感染与原发性胆汁性胆管炎相关的meta分析

黄丽涓, 彭子衡, 彭誉, 张晓梅, 刘小伟

410008 长沙中南大学湘雅医院消化内科

收稿日期:2020-04-10 出版日期:2020-10-31 发布日期:2020-12-18
通讯作者: 刘小伟,Email:liuxw@csu.edu.cn
基金资助:
国家自然科学基金支持项目(81770584)

Association between urinary tract infection and primary biliary cholangitis: a meta-analysis

HUANG Li-juan, PENG Zi-heng, PENG Yu, ZHANG Xiao-mei, LIU Xiao-wei

Department of Gastroenterology,Xiangya Hospital,Central South University,Changsha 410008,China

Received:2020-04-10 Online:2020-10-31 Published:2020-12-18
Contact: LIU Xiao-wei,Email:liuxw@csu.edu.cn

摘要/Abstract

摘要： 目的从循证医学角度分析尿路感染与原发性胆汁性胆管炎(primary biliary cholangitis, PBC)的相关性。方法检索并筛选PubMed、Embase、Web of Science、Cochrane library、万方数据库、维普数据库及中国知网有关尿路感染与PBC的文献,采用Review manager 5.3进行meta分析。结果共纳入7篇文献,PBC组有4 197例,其中有尿路感染1 538例;对照组有21 237例,其中5 092例有尿路感染病史。meta结果显示PBC组比对照组尿路感染发生率增高(OR:1.50,95%CI:1.26~1.77,P<0.01)。按地区进行亚组分析,北美地区PBC人群OR值为1.34,95%CI:1.23~1.46,P<0.01,欧洲地区的OR值为1.79,95%CI:1.37~2.33,P<0.01。结论 PBC人群中尿路感染发生风险高于一般人群,需设计更严谨的临床研究证明两者之间因果关系。

关键词: 原发性胆汁性胆管炎, 尿路感染, meta分析

Abstract: Objective To systematically investigate relationship between the urinary tract infections and PBC from the perspective of evidence-based medicine. Methods PubMed, Embase, Web of Science, Cochrane library, China National Knowledge Infrastructure, Wangfang Database and VIP database were searched to for observational studies on association between association between the urinary tract infections and PBC. And then a meta-analysis was performed by using Review manager 5.3 software. Results A total of 7 studies involving 4197 cases of PBC group and 21237 cases of control group. There were 1538 patients with urinary tract infection in PBC group and 4197 patients in control group. A random effect model was used for overall analysis based on heterogeneity. The results showed that the incidence of urinary tract infections in the PBC group is higher compared with the control group (OR=1.50, 95% CI: 1.26 to 1.77, P<0.00001). By subgroup analysis by region, PBC group had significant increasing risk of UTIs compared to the control group in both North America (OR:1.34, 95% CI: 1.23 to 1.46, P<0.00001) and European (OR:1.79, 95% CI: 1.37 to 2.33, P<0.0001). Conclusion The risk of UTIs is higher in the PBC group than the control group. However, more rigorous clinical studies need to be designed to prove the causal relationship.

Key words: Primary biliary cholangitis, Urinary tract infections, Meta-analysis

黄丽涓, 彭子衡, 彭誉, 张晓梅, 刘小伟. 尿路感染与原发性胆汁性胆管炎相关的meta分析[J]. 肝脏, 2020, 25(10): 1086-1089.

HUANG Li-juan, PENG Zi-heng, PENG Yu, ZHANG Xiao-mei, LIU Xiao-wei. Association between urinary tract infection and primary biliary cholangitis: a meta-analysis[J]. Chinese Hepatolgy, 2020, 25(10): 1086-1089.

参考文献 12

[1]	Gulamhusein AF, Hirschfield GM.Primary biliary cholangitis: pathogenesis and therapeutic opportunities. Nat Rev Gastro Hepat,2020, 17: 93-110.
[2]	EASL Clinical Practice Guidelines: management of cholestatic liver diseases. J Hepatol,2009, 51: 237-267.
[3]	Lindor KD, Gershwin ME, Poupon R, et al.Primary biliary cirrhosis. Hepatology (Baltimore, Md.),2009, 50: 291-308.
[4]	Stang A.Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol,2010, 25: 603-605.
[5]	Varyani FK, West J, Card TR.Primary biliary cirrhosis does not increase the risk of UTIs following diagnosis compared to other chronic liver diseases?. Liver Int,2013, 33: 384-388.
[6]	Lammert C, Nguyen DL, Juran BD, et al.Questionnaire based assessment of risk factors for primary biliary cirrhosis. Digest Liver Dis,2013, 45: 589-594.
[7]	Varyani FK, West J, Card TR.An increased risk of urinary tract infection precedes development of primary biliary cirrhosis. BMC Gastroenterolc,2011, 11: 95.
[8]	Corpechot C, Chretien Y, Chazouilleres O, et al.Demographic, lifestyle, medical and familial factors associated with primary biliary cirrhosis. J Hepatol,2010, 53: 162-169.
[9]	Gershwin ME, Selmi C, Worman HJ, et al.Risk factors and comorbidities in primary biliary cirrhosis: a controlled interview-based study of 1032 patients. Hepatology (Baltimore, Md.),2005, 42: 1194-1202.
[10]	Howel D, Fischbacher CM, Bhopal RS, et al.An exploratory population-based case-control study of primary biliary cirrhosis. Hepatology (Baltimore, Md.),2000,31: 1055-1060.
[11]	Chen J, Jia G, Chen Y, et al. Risk factors of primary biliary cirrhosis in mid-west China. Int J Clin Exp Pathol,2017,10: 2318-+.
[12]	McLellan LK, Hunstad DA. Urinary tract Infection: pathogenesis and outlook. Int J Hepatol,2016, 22: 946-957.

[1]	张梅芹, 沈兰超, 陈国峰, 吕春. 自身免疫性肝炎与原发性胆汁性胆管炎重叠综合征患者的临床病理学特征分析[J]. 肝脏, 2020, 25(9): 965-967.
[2]	于淙, 周培. 粒细胞集落刺激因子治疗肝衰竭有效性及安全性的meta分析[J]. 肝脏, 2020, 25(8): 863-866.
[3]	熊静平, 张跃新. 110例原发性胆汁性胆管炎的临床特点[J]. 肝脏, 2020, 25(1): 36-38.
[4]	张学秀, 姚建宁, 张延祯, 李艳乐, 王春峰, 张连峰. ¹³C-美沙西丁呼气试验在原发性胆汁性胆管炎中的临床应用[J]. 肝脏, 2019, 24(9): 1025-1028.
[5]	王艳, 姚甜甜, 钱建丹, 程浩, 王贵强. 慢性乙型肝炎患者核苷(酸)类似物停药后复发预测因素meta分析[J]. 肝脏, 2019, 24(7): 744-751.
[6]	张鑫岩, 黄馨莹, 于晓松. 恩替卡韦单药与拉米夫定联合阿德福韦酯治疗乙型肝炎肝硬化疗效对比的Meta分析[J]. 肝脏, 2019, 24(4): 392-397.
[7]	陈曦阳光, 吴君. 乙型肝炎肝硬化并发原发性肝癌相关危险因素Meta分析[J]. 肝脏, 2019, 24(4): 398-403.
[8]	李源源, 高莹, 曹蕾, 桂建雄, 周林. 血清PDGF、ApoB/ApoA1与原发性胆汁性肝硬化的相关性分析[J]. 肝脏, 2019, 24(11): 1248-1250.
[9]	李青梅, 张玮. 原发性胆汁性胆管炎90例临床特征分析[J]. 肝脏, 2019, 24(11): 1275-1277.
[10]	尧颖, 高建鹏, 王辉, 张志波, 翟慧勤, 徐智媛. 自身免疫性肝炎-原发性胆汁性胆管炎重叠综合征患者肝组织病理学特征[J]. 肝脏, 2018, 23(9): 769-771.
[11]	朱明鑫, 谭刚. 手足皮肤反应作为索拉菲尼治疗肝细胞癌疗效有益指标的Meta分析[J]. 肝脏, 2018, 23(10): 878-882.
[12]	陈曦阳光, 吴君. 中国糖尿病人群合并肝损伤相关危险因素Meta分析[J]. 肝脏, 2017, 22(9): 800-805.
[13]	丁荣蓉,施光峰,张占卿,周新兰. 替诺福韦酯和恩替卡韦对慢性乙型肝炎初治患者疗效的荟萃分析[J]. 肝脏, 2017, 22(5): 400-403.
[14]	胡晨波,严蓉妹,金宏慧,丁晓红,李仲平. 壳脂胶囊治疗非酒精性脂肪性肝病的Meta分析[J]. 肝脏, 2017, 22(10): 911-916.
[15]	王爱华, 冯欣. 抗炎保肝药物治疗药物性肝损伤疗效和安全性的Meta分析[J]. 肝脏, 2016, 21(6): 471-474.