Meta-analysis Of Helicobacter Pylori Infection And Ischemic Stroke

Background and ObjectiveThe world is facing an epidemic of stroke.Between 1990 and 2010,stroke-related deaths increased by 26%(95%CI,14-32),and disability-adjusted life expectancy increased by 19%(5-26%).Stroke is the second leading cause of death and disability.Numerous epidemiological and clinical studies have shown that hypertension,atrial fibrillation,diabetes,hypercholesterolemia,obesity,smoking,drinking,and high salt are risk factors for stroke.In recent years,research has found that inflammation and inflammation-related atherosclerosis also play an important role in the progression and prognosis of stroke.Helicobacter pylori is a Gram-negative microaerobic bacterium that can be transmitted through feces,oral cavity,close contact,and animal sources.It is a chronic,persistent infection common in clinics.It is distributed all over the world and the infection rate is high for all ages.In developing countries,infection rates are 70%to 90%higher.Helicobacter pylori infection can cause chronic gastritis,ulcers,gastric cancer and many parenteral diseases.Previous research has linked H.pylori infection to stroke.There is currently much controversy about whether Helicobacter pylori infection increases the risk of stroke.One study was thought to be linked to stroke risk,while another found that resistance to Cag A-positive infections increased the risk of stroke and ischemic heart disease.A recent study included 13 case-control studies that showed that chronic Helicobacter pylori infection was significantly associated with an increased risk of stroke,especially non-embolic stroke.One study included 10 prospective observational studies,regardless of whether cytotoxin-associated gene A was positive or negative,indicating no correlation between H.pylori infection and stroke.To more fully assess the impact of H.pylori on stroke,a meta-analysis of prospective and case-control studies was performed.We identified the relationship between H.pylori and ischemic stroke,and what type of stroke is closely related.Assess which of the Helicobacter pylori IgG,anti-Cag A IgG,or 13C urea breath tests is more effective in predicting the risk of ischemic stroke.MethodsWe searched the PubMed,Embase,and Cochrane Library databases,and the latest update was November 1,2019.By inclusion and exclusion criteria,we screened studies on the correlation between H.pylori and stroke.After rigorous literature quality assessment.In total,28 studies were included,including 10 cohort studies and 18 case-control studies.Statistical analysis was performed using Stata 12.0.ResultsThis study showed that H.pylori antibody IgG(anti-Helicobacter pylori IgG),cytotoxin-related gene A antibody IgG(anti-Cag A IgG)or 13C urea breath test and ischemic stroke ratio(OR)were 95%The confidence intervals(95%CI)were 1.33(1.15,1.55),1.59(1.07,2.36),and 1.43(1.06,1.92).The OR(95%CI)of H.pylori antibody positive and atherosclerotic stroke,microvascular stroke,and cardiogenic stroke were 1.65(1.30,2.08),2.34(1.32,4.15),and 0.82(0.53,1.26).Anti-Helicobacter pylori IgG and anti-Cag A IgG are closely related to stroke,and there is no statistically significant difference between the 13C urea breath test and ischemic stroke.Among them,anti-Helicobacter pylori IgG is closely related to atherosclerotic stroke and small vascular stroke,and there is no statistical difference with cardiogenic stroke.Conclusions(1)There is a statistical difference between the anti-H.pylori IgG,anti-Cag A IgG and 13C urea breath test and ischemic stroke.(2)Anti-Helicobacter pylori IgG is closely related to atherosclerotic stroke and small vascular stroke,and there is no statistical difference with cardiogenic stroke.