中国西北地区胃粘膜肠上皮化生危险因素调查

Risk Factors of Gastric Intestinal Metaplasia in Northwest of China

目的:明确中国西北地区人群胃粘膜肠上皮化生的危险因素。方法:通过病例对照研究,采用问卷调查表的形式,纳入了从2014年8月到2015年4月西京医院门诊就诊的具有胃镜检查报告单和/或胃粘膜病理检查报告单的患者。幽门螺杆菌的检测采用13C-/14C-尿素呼气试验或者快速尿素酶试验。结果:本研究共纳入了1800例患者,其中胃粘膜肠上皮化生患者261例。胃粘膜肠上皮化生的危险因素为年龄艹60岁(OR,2.317;95%CI 1.668-3.220;P<0.001)、幽门螺杆菌感染(OR,2.911;95%CI2.339-3.623;P<0.001)、吸烟(OR,2.322;95%CI 1.553-3.470;P<0.001)、胃癌家族史(OR,2.229;95%CI 1.444-3.439;P<0.001)、高盐饮食(OR,1.557;95%CI 1.118-2.168;P=0.009)、辛辣刺激饮食(OR,1.551;95%CI 1.121-2.147;P=0.008)、胆汁反流(OR,1.851;95%CI 1.135-3.021;P=0.014)。结论:我国西北地区胃粘膜肠上皮化生的危险因素为年龄艹60岁、幽门螺杆菌感染、吸烟、胃癌家族史、高盐饮食、辛辣饮食和胆汁反流。

Objective： To find out the risk factors of gastric intestinal metaplasia in northwest of China. Methods： A case-control study was conducted with a well-designed questionnaire, all patients were from the clinics of Xijing hospital with the results of gastroscopy and/or gastric mucosal pathology. All patients were enrolled in the present study from August 2014 to April 2015.1-1. pylori infection was measured by 13C- or 14C-urea breath test or by rapid urease test. Results： A total of 1800 cases were enrolled in the study, among them, 261 cases were with gastric intestinal metaplasia. The multivariate analysis showed that the risk factors of intestinal metaplasia were age≥ 60yr （OR, 2.317; 95% CI 1.668-3.220; P〈0.001）, H. pylori infection （OR, 2.911; 95% CI 2.339-3.623; P〈0.001）, smoking （OR, 2.322; 95% CI 1.553-3.470; P〈0.001）, family history of gastric cancer （OR, 2.229; 95% CI 1.444-3.439; P〈0.001）, high salt diet （OR, 1.557; 95% CI 1.118-2.168; P=0.009）, spicy food （OR, 1.551; 95% CI 1.121-2.147; P=0.008） and bile reflux （OR, 1.851; 95% CI 1.135-3.021; P=0.014）. Conclusions： The risk factors of intestinal metaplasia in northwest of China were patients with age ≥ 60yr, 14. pylori infection, smoking, family history of gastric cancer, high salt diet, spicy food and bile reflux.