淮南地区幽门螺杆菌感染情况及其相关疾病的调查

Investigation on Helicobacter pylori infection and its related diseases in Huainan city

目的探讨淮南地区 H.pylori 感染状况及其与相关疾病的关系。方法用 ELISA 方法检测608人血清抗 H.pylori-IgG,对其中有消化道症状的244例行胃镜检查,并各取胃窦粘膜3块分别进行病理组织学检查及快速尿素酶、改良 Giemsa 染色找 H.pylori 菌。结果①608份血清 H.pylori-IgG 抗体阳性率为52.6％(320/608),儿童和成人分别为42.2％(98/232)和59.0％(222/376),差异具显著性(x^2=16.2,P<0.01);无消化道症状组为35.2％(128/364),有消化道症状组为78.7％(192/244),差异亦具显著性(x^2=111.00,P<0.01);②3岁～、8岁～、13岁～、18岁～、20岁～、30岁～、40岁～、50岁～抗 H.pylori-IgG 阳性率分别为17.8％、36.8％、48.5％、53.1％、53.9％、56.3％、62.4％、64.0％,差异显著(x^2=49.98,P<0.01)。③有症状组中,48例儿童(72.72％)患浅表性胃炎,H.pylori 感染率为81.3％(39/48),2例胃溃疡、6例十二指肠溃疡患者均感染 H.pylori;成人患者中,浅表性胃炎、萎缩性胃炎、十二指肠炎、胃溃疡、十二指肠溃疡H.pylori 感染率分别为90.6％、92.3％、72.7％、95.6％、96.9％,差异具显著性(x^2=11.47,P<0.05)。④H.py-lori 感染的儿童及成人胃粘膜的炎症程度、中性粒细胞增多、嗜酸性粒细胞增多及淋巴滤泡形成的比例,均明显高于 H.pylori 阴性的儿童及成人胃粘膜。儿童胃粘膜淋巴滤泡的形成较成人明显增多(x^2=19.33,P<0.01),而成人则在胃粘膜肠化、萎缩的发生率较儿童更明显。结论 H.pylori 感染在本地区较为多见,且感染率随年龄增长而增加;胃、十二指肠疾病的发生,尤其是胃溃疡、十二指肠溃疡的发生与 H.Pylori 感染似有一定关系;儿童及成人感染 H.pylori 后,胃粘膜呈现不同的组织病理学改变。

Objective To investigate the prevalence of Helicobacter pylori (H.pylori) infection in Huainan,and to study the relationship between the H.pylori infection and disease of digestive tract. Methods Sera of 608 subjects were detected for H.pylori-IgG by ELISA,and 244 individuals with diges- tive tract symptoms were conducted in gastroscopy,and three pieces of mucosa in gastric antrum of them were taken out and detected for H.pylori with rapid urease test,Giemsa staining and histopathologic exam- ination,respectively.H.pylori infection was diagnosed by two criteria at least.Results ①The positive rates of H.pylori-IgG in 608 subjects was 52.6%(320/608),and the positive rates were 42.2%(98/232) in children and 59.0%(222/376) in adults (X^2=16.2,P<0.01),35.2% (128/364) in asymptomatie peoples and 78.7% (192/244) in patients with gastrointestinal symptoms (X^2=111.00,P<0.01);②The positive rates of H.pylori-IgG in individuals aged 3 y～,8 y～,13 y～,18 y～,20 y～,30 y～,40 y～ and 50 y～ were 17.8%, 36.8%,48.5%,53.1%,53.9%,56.3%,62.4% and 64.0%,respectively (X^2=49.98,P<0.01).③In children, 48 (72.7%) symptomatic children were diagnosed for superficial gastritis,H.pylori infection was 81.3%(39/ 48),and the two cases with gastric ulcer and six cases with duodenal ulcer were both confirmed to be H. pylori-positive.In adults,the infection rates of H.pylori in subjects with superficial gastritis,atrophic gas- tritis,duodenitis,gastric ulcer and duodenal ulcer were 90.6%,92.3%,72.7%,95.6% and 96.9%,respec- tively.statistics found significant difference (X^2=11.47,P<0.05).④The severity of inflammation,neu- trophilia,eosinophilia and the formation of lymphoid follicles were more often observed in subjects with H.pylori infection comparing to that without H.pylori infection;Furthermore,the incidence of lymphoid follicles in children with H.pylori infection was significantly higher than that in adults (X^2=19.33,P<0.01), where as the incidence of gastric atrophy and Intestinal metaplasia were significantly higher in adults than that in children.Conclusion The prevalence of H.pylori infection in Huainan areas is high,which increases with ages.The occurrence of disease of digestive tract,especially gastric and duodenal ulcer is associated with H.pylori infection.After H.pylori infection,the gastric mucosa of the children and adults showed different histopathologic alteration.