老年性胃溃疡患者幽门螺旋杆菌临床易感因素分析

Analysis of clinical susceptibility factors to Helicobacter pylori in elderly patients with gastric ulcer

目的幽门螺旋杆菌(Helicobacterpylori,Hp)感染是胃溃疡发病的重要病因,研究探索老年性胃溃疡患者的Hp感染因素,对于降低老年性胃溃疡复发和癌变率,提高老年胃溃疡患者的临床疗效具有重要现实意义。方法选择2018年1月—2020年5月本院收治的103例胃溃疡患者进行调查问卷,根据13C呼气试验结果分为研究组61例(Hp感染)和对照组42例(Hp未感染)两组。单因素分析人口学特征、生活方式、相关病史等变量,具有统计学意义的变量行二分类多因素Logistic回归计算比值比(odds ratio,OR)和95%可信区间,差异有统计学意义(P<0.05)。结果多因素logistic回归分析显示,分餐制、经常吸烟、胃癌家族史是老年胃溃疡患者感染Hp的独立影响因素(P<0.05),有胃癌家族史的老年胃溃疡患者感染Hp的可能性是没有家族史的5.931倍(OR=5.931,95%CI:2.165~16.251),经常吸烟的老年胃溃疡患者感染Hp的可能性是不经常吸烟的2.690倍(OR=2.960,95%CI:1.016~7.122),分餐制的老年胃溃疡患者感染Hp的可能性是没有分餐制的4.363倍(OR=0.363,95%CI:0.140~0.942),为保护性因素。结论本研究提示胃癌家族史、经常吸烟是老年性胃溃疡Hp感染的独立易感因素,而分餐制是老年胃溃疡患者的保护因素,可能有助于避免Hp的感染。

Objective Helicobacter pylori(Hp)infection is an important cause of gastric ulcer.To study and explore Hp infection factors in senile patients with gastric ulcer has important practical significance for reducing the recurrence and cancer rate of senile gastric ulcer and improving the clinical efficacy of elderly patients with gastric ulcer.Methods A questionnaire survey was conducted among 103 patients with gastric ulcer those admitted to our hospital from January 2018 to May 2020.According to the results of 13C breath test,61 patients were divided into the study group(Hp infection)and 42 patients were in the control group(non Hp infection).Univariate analysis was carried on demographic characteristics,lifestyle,related medical history and other variables,and those with statistical significance were analyzed by multivariate Logistic regression,and odds ratio(OR)and 95%confidence interval were calculated.If the p value less than 0.05,it is considered to be statistically significant.Results Multivariate logistic regression analysis showed that eating separately,frequent smoking,and family history of gastric cancer were independent factors influencing Hp infection(P<0.05).Elderly patients with gastric ulcer with a family history of gastric cancer is 5.931 times more likely to get Hp infection than those without family history(OR=5.931,95%CI:2.165~16.251).The possibility of Hp infection in elderly patients with gastric ulcer those who often smoke is 2.690 times to those didn’t smoke(OR=2.960,95%CI:1.016~7.122).The possibility of Hp infection in elderly patients with gastric ulcer those who carry out separate dining is 4.363 times to those didn’t take separate dining(OR=0.363,95%CI:0.140~0.942),it is a protective factor.Conclusions This study suggests that family history of gastric cancer and frequent smoking are independent risk factors for Hp infection in elderly patients with gastric ulcer,and eating separately is a protective factor for elderly patients with gastric ulcer,which may help to avoid Hp infection.