上海地区幽门螺杆菌感染及其危险因素调查

Epidemiological study of Helicobacter pylori infection and its risk factors in Shanghai

目的了解上海地区目前幽门螺杆菌(Hp)感染现状,重新评价Hp感染的危险因素.方法采用整群抽样调查方法,在上海城郊金山地区和上海市区共12个点进行了调查,累计调查人群1925例,男性976例(50.7%),女性949例(49.3%),年龄15～72岁,平均(37±11)岁.采用全国统一的调查问卷形式,内容包括近60个可能与Hp感染有关的问题.所有调查者均采静脉血检查Hp-IgG抗体评价既往感染状态,现场进行14C呼气试验或粪便Hp抗原评价目前感染状态.任何一项检测指标阳性均作为Hp感染阳性标准.分析Hp感染的危险因素.结果共有1822例(94.6%)全部完成了上述3项内容,即一般资料收集、血清抗体检测和呼气试验(或者粪便Hp抗原检测),进入Hp感染率及危险因素资料分析中,血清Hp抗体阳性1080例(59.3%),呼气试验阳性1006例(55.2%).总的Hp感染率为66.4%,男性稍低于女性(64.3% vs 68.4%, P=0.067).不同年龄组Hp感染不同,15～19岁组Hp感染率最低,达到44.4%,20～30岁接近70%,以后稍有回落后再逐渐升高.社会经济状态与Hp感染有显著相关性.生食蔬菜水果、生食前从来不洗等是Hp感染的危险因素.调查还显示人群对Hp感染的知晓只占33.2%,能说出幽门螺杆菌传播途径的比例更低(23.8%).结论上海地区成人Hp感染率维持在高水平,Hp感染与社会经济状况有关,与部分家庭及个人饮食卫生习惯有关.

Objective To explore the Helicobacter pylori (Hp) infection status in Shanghai and its risk factors.Methods A questionnaire survey including 60 items related to Hp was conducted among 1925 persons, 976 males (50.7%) and 949 females (49.3%), aged 37±11 (15~72), selected by cluster sampling in 12 rural and urban areas in Shanghai. Peripheral blood was collected to detect Hp IgG antibody so as to evaluate the past infection status and ~ 14C urea breath test (UBT) was performed so as to evaluate the present infection status. Fecal Hp antigen test was done in the subjects under 18 years of age. Results 1822 of the 1925 subjects (94.6%) underwent the 3 tests. were followed antibody detection and ~ 14C UBT and response with questionnaires. The Hp infection rate was 66.4% in general, and 68.4% in the females, somehow higher than in the males (64.3%, P=0.067). The infection rate was different in different age groups, was the lowest in the age group of 15~19 (44.4%) and the highest 70% in age group of 20~30 (70%), then somewhat lower and gradually became higher. Socio-economic status was related to Hp infection. Hp infection was related with such factors as eating raw vegetables and fruits, and never washing raw vegetables and fruits before eating. The knowledge rate about Hp infection was only 33.2% among the respondents. Only 23.8% of the respondents knew well the transmission route of Hp. Conclusion Hp infection rate is rather high in Shanghai. Hp infection is related to socio-economic status, and family dietary and sanitary habits.