北京城区无症状儿童幽门螺杆菌感染的流行病学调查

Epidemiology of Helicobacter pylori infection in asymptomatic children in Beijing areas

目的了解北京城区无症状儿童人群中幽门螺杆菌(Hp)的现症感染率,并探讨与Hp感染的相关危险因素。方法于2009年9月至2010年2月首都医科大学附属北京儿童医院对北京城区1196名1个月至18岁无症状儿童进行问卷调查,采用酶联免疫吸附法检测每位入选者粪便中Hp抗原(Hp SA)。结果 1196名无症状儿童中粪便Hp SA阳性127例,现症感染率为10.6%,经单因素分析,年龄较大、个人及家庭卫生习惯差、家庭经济收入低、家庭成员内有胃肠病者Hp感染率高。经多因素非条件Logistic回归分析,年龄[OR值(95%CI)为1.300(1.186~1.582)]、家庭经济月收入[OR值(95%CI)为0.767(0.593~0.993)]、家庭同居人口数[OR值(95%CI)为1.413(1.144~1.745)]、家庭居住面积[OR值(95%CI)为0.765(0.622~0.940)]、家庭成员胃病史阳性[OR值(95%CI)为3.518(1.748~7.082)]等是儿童Hp感染的独立相关危险因素。结论北京城区无症状儿童Hp现症感染率较高,并有随着年龄呈递增趋势,有明显的家庭内聚集现象,且与个人及家庭卫生意识关系密切。

Objective To investigate the current rate of Helicobacter pylori infection in asymptomatic children residing in Beijing urban area and to discuss the risk factors that predispose children to such infection. Methods A total of 1196 asymptomatic children aged from 1 month to 18 years were selected from urban schools in Beijing areas. A face to face interview was conducted with a specially designed standard questionnaire. We performed enzyme-linked immunoadsorbent assay （ELISA） for H.pylori stool antigen test to determine H.pylori infection status. Results The overall prevalance of H.pylori was 10.6%. On univariate analysis,risk factors for H.pylori infection included age,poor hygienic habits,lower socioeconomic status,and positive family history of gastrointestinal diseases. Multivariate logitstic regression identified that age,poor hygienic habits,economic status,number of people in the same house,house area,and positive family history of gastrointestinal diseases were the independent risk factors of H.pylori infection. Conclusion H.pylori infection rate among these children is high,and increases with age. H.pylori infection clusters within families and is closely associated with personal and familial hygienic habits.