胃癌患者直系亲属幽门螺杆菌感染情况分析

Helicobacter pylori infection in immediate relatives of patients with gastric cancer

目的调查胃癌患者直系亲属的幽门螺杆菌（Hp）感染情况。方法2010年3月至2011年3月，将86例已确诊胃癌患者的直系亲属共182例定为实验组，选择同期46例与其年龄和性别相匹配的Hp阳性的消化不良患者的126例直系亲属为对照组，进行C14或C13呼气试验检查Hp，并对Hp阳性者进行血清学Hp分型检查。结果实验组182例中142例存在Hp感染，感染率为78．0％，明显高于对照组（47．6％），X2=30．5，P〈0．05；实验组Hp感染者的Hp分型以Hp-1型为主（97例，占68．3％），高于对照组，X2=14．28，P〈0．05；且其平均年龄（46±6）岁明显高于对照组感染者的（38±6）岁，t=13．34，P〈0．05。两组内配偶与子女Hp阳性率分别比较，差异有统计学意义（x2分别为17．03、5．11，均P〈0．05）。父母均感染Hp和父母仅一方感染Hp的儿童Hp感染率（分别为52．8％，43．2％）高于父母双方均未感染Hp的儿童（13．3％），x2值分别为6．80、4．35，P〈0．01或0．05。结论胃癌患者直系亲属的幽门螺杆菌感染率高，且以致病力强的Hp-1型为主。这为中国患者Hp感染流行病学的深入研究提供一些启示。

Objective To investigate the Helicobacter pylori （Hp） infection in the immediate relatives of patients with gastric cancer. Methods One hundred and eighty two immediate relatives of 86 patients with gastric cancer and 126 age and sex-matched immediate relatives of 46 dyspeptic patients were enrolled in the study from March 2010 to March 2011. C14 or C13 urea breath tests were performed and for those with Hp-positive results serological typing was further performed. Results One hundred and forty two out of 182 immediate relatives of gastric cancer patients were Hp positive with a Hp infection rate of 78%, which was significantly higher than that of immediate relatives of dyspeptic patients （ 78.0% vs 47.6%, X2 = 30. 5, P 〈 0. 05, P = 0. 006 ）. The average age of former was significantly higher than that of latter （46±6 y vs 38 ±6 y; t = 13.34,P 〈 0. 05）. The rate of serological type Hp-1 in immediate relatives of cancer patients was significantly higher than that of those of dyspeptic patients （68.3% vs 38.3% , X2 = 14. 28,P 〈 0. 05 ）. The infection rate of children, both parents of whom were infected with Hp and only one parent infected with Hp （52. 8% , 43.2% , respectively） was higher than that of children whose parents were not infected with Hp （ 13.3% ） （ X2 = 6. 80, P 〈 0. 01 and X2 = 4. 35, P 〈 0. 05 ）. Conclusions The Hp infection rate is high in immediate familial members of gastric cancer patients and the predominant serological type of Hp is Hp-1.