30岁以下青年幽门螺旋杆菌患者临床特征及预后因素分析

Analysis of clinical characteristics and prognostic factors of patients infected with Helicobacter pylori under 30 years old

目的 分析30岁以下青年幽门螺旋杆菌(Hp)患者临床特征及影响预后的危险因素,为30岁以下青年Hp阳性患者根除Hp提供理论依据。方法 选取2017年12月至2020年12月上海市静安区闸北中心医院收治的上消化道症状患者565例,所有患者Hp均为阳性,所有患者均行幽门螺杆菌四联根除疗法,根据患者治疗后Hp转阴情况分为预后较好组(Hp转阴,n=374)和预后不佳组(Hp未转阴,n=191)。采用该院自制的调查问卷分析两组年龄、性别、家族性胃肠道疾病史、生活习惯(是否长期吸烟、是否嗜酒)、饮食习惯(饮食不规律、喜食刺激性食物)、DOB基线值、治疗依从性等,采用logistic回归对可能影响Hp阳性患者预后的因素进行分析。结果 565例Hp阳性患者男性347例,女性218例,平均年龄为(23.49±4.29)岁,年龄18~24岁393例(69.56%)、25~29岁172例(30.44%);上消化道疾病诊断结果分别为胃癌5例(0.88%)、消化性溃疡174例(30.80%)、慢性胃炎318例(56.28%)、反流性食管炎68例(12.04%);两组患者年龄、性别、家族性胃肠道疾病史、是否酗酒间差异无统计学意义(P>0.05);两组患者在长期吸烟、饮食不规律、喜食刺激性食物、喜食刺激性食物、治疗依从性、DOB基线值间差异具有统计学意义(P<0.05);logistic回归分析结果显示长期吸烟、治疗依从性差、DOB值高是影响Hp阳性患者预后的独立危险因素(P<0.05)。结论 30岁以下青年Hp阳性患者上消化道疾病主要以慢性胃炎、消化性溃疡为主,长期吸烟、治疗依从性差、DOB值高是影响患者预后的独立危险因素,治疗Hp感染时应提高患者治疗依从性,加强对高DOB值和吸烟患者的干预。

Objective To analyze the clinical characteristics and prognostic risk factors of helicobacter pylori(Hp) infected patients under 30 years old, and to provide a theoretical basis for the eradication of Hp in young Hp-positive patients under 30 years old. Methods A total of 565 patients with upper gastrointestinal symptoms admitted to our hospital from December 2017 to December 2020 were selected.All patients were Hp positive, and all patients were treated with quadruple eradication therapy of Helicobacter pylori.According to the Hp negative status after treatment, the patients were divided into good prognosis group(Hp negative, n=374) and poor prognosis group(Hp not negative, n=191).A self-made questionnaire was used to analyze the age, gender, familial history of gastrointestinal diseases, life habits(long-term smoking, and drinking),eating habits(irregular diet, and excitant food),DOB baseline value, and treatment compliance of the two groups.Logistic regression was used to analyze the factors that may affect the prognosis of HP positive patients. Results Among the 565 Hp positive patients, 347 were males and 218 were females, with an average age of(23.49±4.29) years, 393(69.56%) aged 18-24 years old and 172(30.44%) aged 25-29 years old.The diagnosis results of upper gastrointestinal diseases were 5 cases of gastric cancer(0.88%),174 cases of peptic ulcer(30.80%),318 cases of chronic gastritis(56.28%),and 68 cases of reflux esophagitis(12.04%).There were no significant differences in age, sex, family history of gastrointestinal diseases and alcoholism between the two groups(P>0.05).There were statistically significant differences between the two groups in long-term smoking, irregular diet, preference for stimulating food, treatment compliance and baseline value of DOB(P<0.05).The results of logistic regression analysis showed that long-term smoking, poor treatment compliance and high DOB value were independent risk factors affecting the prognosis of Hp positive patients(P<0.05). Conclusion Chronic gastritis and peptic ulcer are the main upper gastrointestinal diseases in Hp-positive young patients under 30 years old.Long-term smoking, poor treatment compliance and high DOB value are independent risk factors affecting the prognosis of patients.Treatment compliance of patients should be improved, and intervention should be strengthened in patients with high DOB value and smoking.