幽门螺杆菌感染的家庭聚集性现状调查和分析

Investigation and Analysis of Familial Aggregation of Helicobacter pylori Infection

背景:幽门螺杆菌(Hp)感染是重要的公共卫生问题,其传播方式目前尚未完全清楚,但人-人传播途径已获得普遍认可,故Hp感染可能存在家庭聚集性。目的:调查Hp阳性患者家庭成员的Hp感染情况并分析Hp感染的家庭聚集性。方法:选取2018年1月—2019年1月行14C-尿素呼气试验(14C-UBT)检查者976例。根据Hp感染情况将受检者分为Hp阳性组(病例组)和Hp阴性组(对照组),鼓励所有受检者全部家庭成员行Hp检测,探讨两组家庭成员Hp感染情况以及病例组夫妻间Hp感染一致性、父母Hp阳性与子女Hp感染的关系,采用二项分布拟合优度检验探讨Hp感染的家庭聚集性。结果:完成调查的病例组493个完整家庭中,父母、配偶、子女的Hp阳性率分别为70.6%、62.1%、65.9%,均显著高于对照组父母、配偶、子女的Hp阳性率(分别为63.2%、54.4%、56.7%)(P<0.05)。462对病例组夫妻中,双方Hp均阳性者287对,一方阳性者175对,McNemar检验结果显示,夫妻间Hp感染情况无明显差异(P>0.05)。548名病例组子女中,Hp阳性者361名,其感染率随父母感染率增加而升高(P<0.05)。拟合优度检验结果显示,Hp感染的实际分布户数与理论分布户数相比差异有统计学意义(P<0.05)。结论:Hp感染存在一定的家庭聚集性,当家庭中一名成员感染Hp时可导致父母、配偶和子女的Hp感染风险增加。

Background: Helicobacter pylori (Hp) infection is an important public health problem, and the transmission mode of Hp is not yet fully understood, however, human-to-human transmission route has been widely recognized, thus familial aggregation may occur for Hp infection. Aims: To explore the Hp infection in family members of Hp-positive patients and to analyze the familial aggregation of Hp infection. Methods: A total of 976 patients who underwent 14 C-urea breath test ( 14 C-UBT) from January 2018 to January 2019 were enrolled. According to Hp infection, the subjects were divided into Hp-positive group (case group) and Hp-negative group (control group), and all family members of all the subjects were encouraged to detect Hp infection. The Hp infection of family members in the two groups, the consistence of Hp infection between husband and wife, and the relationship between Hp-positive parents and Hp infection of children in case group were analyzed, and the goodness-of-fit test for binomial distribution was used to explore familial aggregation of Hp infection. Results: Among the 493 complete families who completed the survey, Hp-positivity rate in parents, spouses, children in case group were 70.6%, 62.1%, 65.9%, respectively, and were significantly higher than those in parents, spouses, children in control group (63.2%, 54.4%, 56.7%, respectively)( P <0.05). Among the 462 couples in case group, 287 pairs were positive in couples, and 175 pairs were positive in one part. McNemar test showed that there was no significant difference in Hp infection between husband and wife ( P >0.05). Among 548 children in case group, 361 children were Hp positive, and the infection rate was increased with the increase of parental infection ( P < 0.05 ). The goodness- of-fit test showed that there were statistically significant differences in the actual households distribution and theoretical households distribution of Hp infection ( P <0.05). Conclusions: There is a certain familial aggregation of Hp infection. When a member of the family is infected, the risk of Hp infection of parents, spouses and children may increase.