苏州城区婴幼儿幽门螺杆菌感染危险因素研究

Risk factors of helicobacter pylori infection in infants and young children in Suzhou city

目的了解苏州城区婴幼儿幽门螺杆菌(Hp)感染危险因素,为婴幼儿Hp感染的预防提供积极有效的措施,降低儿童Hp的感染率。方法随机抽取441名在苏州市立医院儿童保健科进行健康体检的婴幼儿进行问卷调查,并采用幽门螺杆菌唾液检测试剂(HPS)方法检测口腔Hp感染。通过单因素配对资料χ2检验及多因素Logistic回归分析筛选出危险因素。结果 441名婴幼儿HPS检测阳性者212例(48.1%),其中0月~、6月~、1岁~、2~3岁HPS的阳性率分别为27.6%、56.1%、56.7%、63.5%,感染率呈现随年龄增长而增加的趋势。而辅食添加、年龄、家庭人口数多、儿童的个人卫生如爱啃手指等、照养人的带养方式如喂食前咀嚼或咬断食物等,照养人的个人习惯如饭前不洗手,父母及家庭成员胃病史等为婴幼儿幽门螺杆菌感染的高危因素。结论婴幼儿的Hp感染主要通过口-口和粪-口途径传播。实行家庭分餐制或应用公筷,注意手卫生(母乳喂养前和准备食物前应洗手),教育小儿从小养成良好的饮食卫生习惯,改善家庭生活水平,对预防感染有重要意义。

Objective To identify the risk factors of helicobacter pylori （Hp） infection in infants and young children in Suzhou City. Methods A random sample of 441 infants and young children who had regular physical examinations in Child Healtbcare Department of Suzhou Municipal Hospital were enrolled as research subjects. Oral Hp infection was diag nosed by method of saliva test board （HPS）. Related demographic data were obtained by a structured questionnaire sent to the parents of these children. Categorical variables were analysed with chi-square test in univariate factor analysis. The sub- stantially significant factors were included in Logistic regression analysis. Results Among 441 infants and young chil- dren,212（48.1~） were diagnosed as HPS test positive. HPS positive rates in the age periods of 0 months~ ,6 months~ ,1 years old~ ,2~3 years old were 27.6 ~//00,56.1 0~, 56.7 ~//0, and 63.5~ respectively, which meaned obviously that the preva- lence increased with age. The following factors were the high risks of Hp infection：complementary foods introduction, age, too much family members,children personal hygiene practices such as chewing fingers, caregivers＂ children raising patterns such as chewing and crushing food before feeding and caretaker personal habits （no washing hands before eating） and fami- lies＂ stomach diseases history. Conclusions The main transmission routes of Hp infection are oral to oral and fecal to oral. It makes great sense to Use individual plates or serving chopsticks in family, pay attention to hands hygiene （including wash- ing hands before breast feeding and preparing food） ,educate infants to develop excellent dietary health habits, and improve family living standards.