目的对幽门螺杆菌(Hp)感染与缺血性脑卒中(IS)及其亚型的相关性进行Meta分析,探讨Hp感染是否为IS及其亚型的危险因素。方法计算机检索MEDLINE、EMBASE及Cochrance Collaboration database电子数据库,检索时限为1 995～2009年。由2名评价者对文献的质量进行评价,纳入相关的病例对照研究。采用Cochrane协作网提供的RevMan 5.0软件对纳入文献进行Meta分析,并进一步进行异质性检验、敏感性分析及偏倚评估。结果共纳入11篇相关文献,其中与IS相关9篇(病例组1575例,对照组1 720例),与大动脉粥样硬化性脑卒中(LAA)相关7篇(病例组510例,对照组944例)。异质性检验提示,Hp与IS及LAA的研究间均存在异质性(I~2=58%,I~2=60%)。病例组与对照组的Hp感染率差异存在统计学意义(OR=1.57,95%CI:1.23～1.99);Hp感染与LAA亦存在相关性(OR=2.24,95%CI:1.46～3.43)。敏感性分析提示结果稳定。漏斗图表明存在发表偏倚,提示缺少小样本的阴性结果文献。结论 Hp感染是IS的危险因素,且与LAA的相关性更为密切;病例对照研究论证强度较低,仍需更多大样本及前瞻性研究以证实Hp在IS及其亚型发病中的作用。 Objective To analyze the correlation between Helicobacter pylori (Hp) infection and ischemic stroke (IS) and its subtypes and to investigate whether Hp infection is a risk factor for IS and its subtypes. Methods The databases of MEDLINE, EMBASE and Cochrance Collaboration database were searched by computer, and the retrieval time was from1995to2009. Two reviewers evaluated the quality of the literature and included relevant case-control studies. RevMan 5.0 software, available from the Cochrane Collaboration, was used to perform meta-analyzes of included literature and to further conduct heterogeneity tests, sensitivity analyzes, and bias assessments. Results A total of 11 related articles were included, of which 9 were related to IS (1575 in case group and 1 720 in control group), 7 were associated with large atherothrombosis (LAA) (510 in case group and 944 in control group example). Heterogeneity tests showed heterogeneity between Hp and IS and LAA (I ~ 2 = 58%, I ~ 2 = 60%). There was a significant difference in Hp infection rates between cases and controls (OR = 1.57, 95% CI: 1.23-1.99). Hp infection was also associated with LAA (OR = 2.24, 95% CI: 1.46-3.43). Sensitivity analysis suggests stable results. Funnel plots indicate the existence of publication bias, suggesting a lack of small sample negative result literature. Conclusions Hp infection is a risk factor for IS and is more closely related to LAA. The case-control study has a lower intensity of proof and needs more large sample and prospective studies to confirm the role of Hp in the pathogenesis of IS and its subtypes .