Meta-Analysis on Relationship between Helicobacter Pyloric Infection and the Subtypes of Ischemia Stroke_Chinese Journal of Evidence-Based Medicine

Authors：

YU Liang ,  TONG Weijun

School of Radiation Medicine and Public Health, Department of Medicine of School University, Suzhou 215123, China;

Corresponding author：

TONG Weijun, Email: t_weijun@yahoo.com.cn

Keywords：

Cerebral infarction; Ischemia stroke; Helicobacter pyloric; Meta-analysis; Infection

DOI：

10.7507/1672-2531.20090107

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective 　To systematically review the relationship between helicobacter pyloric (HP) infection and ischemia stroke.
Methods 　We searched MEDLINE, BIOSIS, VIP, and China Full Text Journal databases to identify the studies that studied the relationship between HP infection and ischemia stroke. All the studies were strictly screened according to the inclusion criteria, and meta-analyses were performed for the included studies using RevMan 4.2 software.
Results 　Eleven case-control studies involving 1 530 patients with ischemia stroke and 1 451 health controls were included. The results of meta-analyses showed that there was a significant difference in the infection ratio of HP between the patients with ischemia stroke and health controls (OR=1.77, 95%CI 1.38 to 2.28, P lt;0.0001), but this difference was not been found after adjusting some related risk factors (1.22, 95%CI 0.93 to 1.59, P=0.15). The results of subgroup meta-analyses showed these differences were only found in the LAA (large-artery atherosclerosis) subgroup (OR=3.65, 95%CI 2.58 to 5.17) and the SAA (small-artery atherosclerosis) subgroup (OR=1.74, 95%CI 1.30 to 2.34), but was not found in the CE (cardiogenic cerebral embolism) subgroup (OR=1.08, 95%CI 0.58 to 2.02).
Conclusion 　HP infection is associated with ischemia stroke, but the relationships between HP infection and the subtypes of ischemia stroke are different. The association between HP and LAA is ber than that between HP and the other subtypes. More evidence is needed to prove whether Helicobacter pyloric infection is an independent risk factor of ischemia stroke.

Citation： YU Liang,TONG Weijun. Meta-Analysis on Relationship between Helicobacter Pyloric Infection and the Subtypes of Ischemia Stroke. Chinese Journal of Evidence-Based Medicine, 2009, 09(5): 593-598. doi: 10.7507/1672-2531.20090107 Copy

1.	pneumoniae and risk of ischemic stroke subtypes: Results from a population-based case-control study. Stroke, 2001, 32(10): 2253-2258.
2.	Zhang LF, Yang J, Hong Z, et al. Proportion of different subtypes of stroke in China. Stroke, 2003, 34(9): 2091-2096.
3.	Ameriso SF, Fridman EA, Leiguarda RC, et al. Detection of Helicobacter pylori in human carotid atherosclerotic plaques. Stroke, 2001, 32(2): 385-391.
4.	Markus HS, Mendall MA. Helicobacter pylori infection: a risk factor for ischaemic cerebrovascular disease and carotid atheroma. J Neurol Neurosurg Psychiatry, 1998, 64(1): 104-107.
5.	Masoud SA. Arami MA. Kucheki E. Association between infection with Helicobacter pylori and cerebral noncardioembolic ischemic stroke. Neurology India, 2005, 53(3): 303-306.
6.	Moayyedi P, Carter AM, Braunholtz D, et al. Helicobacter pylori infection in subjects with acute ischemic stroke. Dig Liver Dis, 2003, 35(1): 16-19.
7.	Majka J, Róg T, Konturek PC, et al. Influence of chronic Helicobacter pylori infection on ischemic cerebral stroke risk factors. Med Sci Monit, 2002, 8(10): CR675-684.
8.	段和力, 石丽霞, 陈迎春, 等. 幽门螺杆菌感染与脑出血及脑梗死的相关性分析. 华北煤炭医学院学报, 2005, 7(5): 557-558.
9.	王东风, 徐宁, 周君同. 老年人脑梗死和心肌梗死与幽门螺旋杆菌感染的关系. 中华老年医学杂志, 2001, 20(1): 53.
10.	刘琮蔚, 杨晓熹, 任艺, 等. 幽门螺旋杆菌感染与缺血性脑血管病的关系. 天津医药. 2004, 32(7): 430.
11.	Grau AJ, Buggle F, Lichy C, et al. Helicobacter pylori infection as an independent risk factor for cerebral ischemia of atherothrombotic origin. J Neurol Sci, 2001, 186(1-2): 1-5.
12.	Preusch MR, Grau AJ, Buggle F, et al. Association between cerebral ischemia and cytotoxin-associated gene-A-bearing strains of Helicobacter pylori. Stroke, 2004, 35(8): 1800-1804.
13.	Heuschmann PU, Neureiter D, Gesslein M, et al. Association between infection with Helicobacter pylori and Chlamydia.
14.	Park MH, Min JY, Koh SB, et al. Helicobacter pylori infection and the CD14 C(-260)T gene polymorphism in ischemic stroke. Thrombosis Research, 2006, 118(6): 671-677.
15.	刘信荣, 段和力, 周波, 等. 幽门螺杆菌感染与脑梗死相关性初探. 中国综合临床, 2003, 19(7): 614-616.
16.	Lichtenstein MJ, Mulow CD, Elwood PC. Guidelines for reading case-control study. J Chron Dis, 1987, 40(9): 893-895.
17.	Wang KJ, Wang RT. Meta-analysis on the epidemiology of Helicobacter pylori infection in China. Zhonghua Liu Xing Bing Xue Za Zhi, 2003, 24(6): 443-446.
18.	Pasceri V, Patti G, Cammarota G, et al. Virulent strains of Helicobacter pylori and vascular diseases: a meta-analysis. Am Heart J, 2006, 151(6): 1215-1222.
19.	Danesh J, Collins PR. Chronic infections and coronary heart disease: is there a link? Lancet, 1997, 350(9075): 430–436.
20.	Phull PS, Gower JD, Price AB, et al. Alpha-tocopherol antioxidant levels in chronic gastritis: correlation with mucosal neutrophil infiltration. Gut, 1993, 34(suppl 1): T133.
21.	Hansen PS, Go MF, Varming K, et al. Proinflammatory activation of neutrophils and monocytes by Helicobacter pylori in patients with different clinical presentations. Infect Immun, 1999, 67(6): 3171-3174.
22.	Grau AJ, Buggle F, Heindl S, et al. Recent infection as a risk factor for cerebrovascular ischemia. Stroke, 1995, 26(3): 373-379.
23.	Glynn J. Helicobacter pylori and the heart. Lancet, 1994, 344(8916):146.

1. pneumoniae and risk of ischemic stroke subtypes: Results from a population-based case-control study. Stroke, 2001, 32(10): 2253-2258.
2. Zhang LF, Yang J, Hong Z, et al. Proportion of different subtypes of stroke in China. Stroke, 2003, 34(9): 2091-2096.
3. Ameriso SF, Fridman EA, Leiguarda RC, et al. Detection of Helicobacter pylori in human carotid atherosclerotic plaques. Stroke, 2001, 32(2): 385-391.
4. Markus HS, Mendall MA. Helicobacter pylori infection: a risk factor for ischaemic cerebrovascular disease and carotid atheroma. J Neurol Neurosurg Psychiatry, 1998, 64(1): 104-107.
5. Masoud SA. Arami MA. Kucheki E. Association between infection with Helicobacter pylori and cerebral noncardioembolic ischemic stroke. Neurology India, 2005, 53(3): 303-306.
6. Moayyedi P, Carter AM, Braunholtz D, et al. Helicobacter pylori infection in subjects with acute ischemic stroke. Dig Liver Dis, 2003, 35(1): 16-19.
7. Majka J, Róg T, Konturek PC, et al. Influence of chronic Helicobacter pylori infection on ischemic cerebral stroke risk factors. Med Sci Monit, 2002, 8(10): CR675-684.
8. 段和力, 石丽霞, 陈迎春, 等. 幽门螺杆菌感染与脑出血及脑梗死的相关性分析. 华北煤炭医学院学报, 2005, 7(5): 557-558.
9. 王东风, 徐宁, 周君同. 老年人脑梗死和心肌梗死与幽门螺旋杆菌感染的关系. 中华老年医学杂志, 2001, 20(1): 53.
10. 刘琮蔚, 杨晓熹, 任艺, 等. 幽门螺旋杆菌感染与缺血性脑血管病的关系. 天津医药. 2004, 32(7): 430.
11. Grau AJ, Buggle F, Lichy C, et al. Helicobacter pylori infection as an independent risk factor for cerebral ischemia of atherothrombotic origin. J Neurol Sci, 2001, 186(1-2): 1-5.
12. Preusch MR, Grau AJ, Buggle F, et al. Association between cerebral ischemia and cytotoxin-associated gene-A-bearing strains of Helicobacter pylori. Stroke, 2004, 35(8): 1800-1804.
13. Heuschmann PU, Neureiter D, Gesslein M, et al. Association between infection with Helicobacter pylori and Chlamydia.
14. Park MH, Min JY, Koh SB, et al. Helicobacter pylori infection and the CD14 C(-260)T gene polymorphism in ischemic stroke. Thrombosis Research, 2006, 118(6): 671-677.
15. 刘信荣, 段和力, 周波, 等. 幽门螺杆菌感染与脑梗死相关性初探. 中国综合临床, 2003, 19(7): 614-616.
16. Lichtenstein MJ, Mulow CD, Elwood PC. Guidelines for reading case-control study. J Chron Dis, 1987, 40(9): 893-895.
17. Wang KJ, Wang RT. Meta-analysis on the epidemiology of Helicobacter pylori infection in China. Zhonghua Liu Xing Bing Xue Za Zhi, 2003, 24(6): 443-446.
18. Pasceri V, Patti G, Cammarota G, et al. Virulent strains of Helicobacter pylori and vascular diseases: a meta-analysis. Am Heart J, 2006, 151(6): 1215-1222.
19. Danesh J, Collins PR. Chronic infections and coronary heart disease: is there a link? Lancet, 1997, 350(9075): 430–436.
20. Phull PS, Gower JD, Price AB, et al. Alpha-tocopherol antioxidant levels in chronic gastritis: correlation with mucosal neutrophil infiltration. Gut, 1993, 34(suppl 1): T133.
21. Hansen PS, Go MF, Varming K, et al. Proinflammatory activation of neutrophils and monocytes by Helicobacter pylori in patients with different clinical presentations. Infect Immun, 1999, 67(6): 3171-3174.
22. Grau AJ, Buggle F, Heindl S, et al. Recent infection as a risk factor for cerebrovascular ischemia. Stroke, 1995, 26(3): 373-379.
23. Glynn J. Helicobacter pylori and the heart. Lancet, 1994, 344(8916):146.

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