拉萨市某医院5年就诊患者幽门螺杆菌检测结果分析

Helicobacter pylori infection in Lhasa People＇s Hospital from 2009 to 2013

目的 了解西藏自治区拉萨市某医院就诊患者幽门螺杆菌（Hp）的感染状况.方法 回顾分析2009年1月至2013年12月于拉萨市人民医院就诊且行14C-尿素呼气试验患者的检查结果及临床资料,比较不同年度、不同疾病患者Hp检测结果.结果 2 908例患者Hp阳性者1 518例（52.20％）.男性患者Hp阳性1 061例（1 061/1 939,54.72％）,高于女性患者（457/969,47.16％）,x2=14.788,P=0.000.2009年至2013年每年患者Hp阳性率分别为55.97％（267/477）、49.79％（239/480）、54.66％（375/686）、52.06％ （291/559）及49.15％（347/706）,2013年Hp的阳性率显著低于2009年和2011年（P值分别为0.021、0.040）.患者中藏族、汉族及回族Hp阳性率差异无统计学意义.2 908例患者中2 020例患者进行了内镜检查,其中1 098例患者（54.36％） Hp阳性.浅表性胃炎组Hp阳性率（39.91％）显著低于糜烂性胃炎组（x2=30.143,P=0.000）、胃溃疡组（x2=22.434,P=0.000）、胃息肉组（x2=9.627,P=0.002）、胃癌组（x2=9.506,P=0.002）、十二指肠球部溃疡组（x2=54.158,P=0.000）、十二指肠球炎组（x2=14.966,P=0.000）及复合性溃疡组（x2=8.582,P=0.003）.十二指肠球部溃疡患者Hp阳性率（68.42％）显著高于浅表性胃炎组（x2=54.158,P=0.000）、糜烂性胃炎组（x2=6.733,P=0.009）、萎缩性胃炎组（x2=21.496,P=0.000）及胃溃疡组（x2=8.940,P=0.003）.结论 拉萨地区医院就诊患者Hp检测阳性率有下降趋势,十二指肠球溃疡患者Hp阳性率仍较高.

Objective To investigate the infection status of Helicobacter pylori （Hp） in a Lhasa hospital.Methods A retrospective survey of Hp infection from 2009 to 2013 was conducted in Lhasa People＇s Hospital.The data of 14C-urea breath test and gastroscopy were analyzed.Results A total of 2 908 patients were enrolled,1 518 （52.20％） were Hp positive,including 1 061 males （1 061/1 939,54.72％） and 457 females （457/969,47.16％）.The Hp infection rate in males was higher than that in females （x2 =14.788,P =0.000）.The Hp infection rate by years from 2009 to 2013 was 55.97％ （267/477）,49.79％ （239/480）,54.66％ （375/686）,52.06％ （291/559） and 49.15％ （347/706）,respectively.The infection rate in 2013 was significantly lower than that in 2009 and 2011 （P =0.021,0.040）.There were no significant differences in Hp infection rates among Tibetan,Han and Hui ethnic groups.In 2020 cases who underwent endoscopic examination,1 098 had Hp positive （54.36％）.The Hp infection rate in chronic superficial gastritis group（39.91％） was significantly lower than that in erosive gastritis （x2 =30.143,P =0.000）,gastric ulcer （x2 =22.434,P =0.000）,gastric polyps （x2 =9.627,P=0.002）,gastric cancer （x2 =9.506,P =0.002）,duodenal ulcer （x2 =54.158,P =0.000）,duodenitis （x2 =14.966,P =0.000） and compound ulcer groups （x2 =8.582,P =0.003）.The Hp infection rate in duodenal ulcer group （68.42％） was significantly higher than that in chronic superficial gastritis （x2 =54.158,P =0.000）,erosive gastritis （x2 =6.733,P =0.009）,atrophic gastritis （x2 =21.496,P =0.000） and gastric ulcer groups （x2 =8.940,P =0.003）.Conclusion Hp infection rate appears a decreasing trend in Lhasa area in last 5 years; among various gastro-duodenal diseases patients with duodenal ulcer have a highest Hp infection rate.