上海地区健康体检者幽门螺杆菌感染率调查分析

Infection Rate of Helicobacter Pylori of Healthy Controls in Shanghai

目的调查上海地区健康体检者幽门螺杆菌(H.pylori)感染率。方法采用芯片法检测上海地区健康体检者血清中相应的抗体,包括尿素酶(Ure)、细胞毒素相关蛋白(CagA)、空泡毒素相关蛋白(VacA)、热休克蛋白(Hsp60)及硝基还原酶(RdxA)。以Ure阳性为H.pylori感染;以CagA、VacA抗体中1种阳性或同时阳性为Ⅰ型H.pylori感染,为毒力菌株感染;仅出现Ure抗体阳性,而CagA、VacA抗体阴性为Ⅱ型H.pylori感染。结果 855例体检者H.pylori感染率为45.3%(387/855),其中松江为41.8%(23/55)、嘉定为45.0%(36/80),金山为48.7%(19/39),闵行为35.7%(30/84)、奉贤为35.5%(125/352),崇明为56.8%(71/125),徐汇为39.5%(30/76),宝山为52.2%(23/44),不同地区体检者H.pylori感染率间差异有统计学意义(χ2=21.825,P=0.003)。各地区内男女体检者H.pylori感染率比较,差异均无统计学意义(P>0.05)。855例体检者毒力菌株感染率为22.5%(196/855),各地区毒力菌株感染率分别为:松江8.2%(10/55)、嘉定18.8%(15/80)、金山35.9%(14/39)、闵行10.7%(9/84)、奉贤25.6%(90/352)、崇明31.2%(39/125)、徐汇15.8%(12/76)、宝山15.9%(7/44);各地区毒力菌株感染率间差异有统计学意义(χ2=21.945,P=0.003)。结论上海不同地区H.pylori感染率间有差异,与各地区体检者个人、家庭卫生意识、习惯不同有关;毒力菌株感染率的不同与同一地区内不同地理位置H.pylori菌株存在较大差异有关。

Objective To investigate the infection rate of helicobacter pylori （H. pylori） of healthy controls in Shang- hai. Methods Chip assay was used to detect the corresponding antibodies in serum in healthy controls, including urease （Ure） , cytotoxin - associated protein （ CagA）, vacuolating toxin - associated protein （VacA） , heat shock protein （Hsp60） and nitroreductas~ （RdxA）. Ure being positive stood for H. pylori infection; CagA, VacA antibodies both or either being posi- tive for type [ H. pytori infection or highly virulent strain infection; Ure being positive but CagA, VaeA antihodies being nega- tive for type lI H. pylori infection. Results The H. pylori infection rate of 855 healthy controls was 45.3% （387/855） , there- into 41.8% （ 23/55 ） in Songjiang District, 45.0% （ 36/80 ） in Jiading District, 48.7% （ 19/39 ） in Jinshan District, 35.7% （30/84） in Minhang District, 35.5% （125/352） in Fengxian District, 56. 8% （71/125） in Chongming District, 39. 5% （30/76） in Xuhui District, 52. 2% （23/44） in Baoshan District. The difference was significant （X2 =21. 825, P = 0. 003 ） , but there was no difference between males and females （ P 〉 0.05 ）. The virulent strain infection rate was 22. 5% （196/855）, thereinto 8.2% （10/55） in Songjiang District, 18.8% （15/80） in Jiading District, 35.9% （14/39） in Jins- han District, 10. 7% （9/84） in Minhang District, 25.6% （90/352） in Fengxian District, 31.2% （39/125） in Chongming District, 15.8% （12/76） in Xuhui District, 15.9% （7/44） in Baoshan District. The difference was significant （X2 = 21. 945, P = 0. 003 ）. Conclusion There is difference in H. pylori infection rate between different districts of Shanghai, which is related to the health awareness and habits of the controls from different districts. Difference in virulent strain infection rate is associated with the H. pylori stains at different geographic location in the same region.