炎症性肠病患者幽门螺杆菌感染调查及其危险因素分析

Investigation and Risk Factors of Helicobacter pylori Infection in Patients with Inflammatory Bowel Disease

目的探究炎症性肠病(inflammatory bowel disease,IBD)患者幽门螺杆菌(Helicobacter pylori,Hp)感染现况,并初步分析其发生Hp感染的危险因素。方法2020年1月1日—2020年12月31日通过发送电子问卷的方式对北京协和医院长期随访IBD患者及年龄、性别与之相匹配的北京社区居民展开调查。收集两组人群一般资料、Hp感染相关信息、环境因素等资料。比较两组人群Hp阳性率差异并分析IBD患者Hp感染相关危险因素。结果经倾向性评分匹配后,最终纳入本研究IBD患者122例、社区居民1739例。两组人群倾向性评分直方图高度一致。IBD患者Hp阳性率显著低于社区居民(13.1%比42.7%,P<0.001),且两组Hp阳性率均随年龄增高呈逐渐升高趋势,但组内比较差异均无统计学意义(P均>0.05)。单因素分析显示,IBD患者中Hp阳性者长期共餐者Hp感染的比例显著高于Hp阴性者(43.8%比18.9%,P=0.006)。结论IBD患者Hp感染率较社区居民降低,其发生Hp感染可能与长期共餐者Hp阳性有关。

Objective To investigate the rate and risk factors of Helicobacter pylori(Hp)infection in patients with inflammatory bowel disease(IBD).Methods A survey was conducted from January 1,2020 to December 31,2020 by sending an electronic questionnaire to long-term follow-up IBD patients of Peking Union Medical College Hospital and age-sex-matched Beijing community residents.General information,information related to Hp infection and environmental factors were collected from the two groups.The differences in Hp positivity rates between the two groups and IBD patients with different clinical profiles were compared.Results After propensity score matching,122 patients with IBD and 1739 community residents were finally included in this study.The histograms of propensity score values were highly consistent between the two groups.The ratio of Hp infection was significantly lower in IBD patients than in the community residents(13.1%vs.42.7%,P<0.001).The ratio of Hp infection in both groups increased with age but showed no statistical significance(all P>0.05).Univariate analysis showed that the IBD patients with Hp positive co-diners had a significantly higher ratio of Hp infection than those with Hp negative co-diners(43.8%vs.18.9%,P=0.006).Conclusions The Hp infection rate was lower in IBD patients than in community residents.The possible risk factor may be co-dining with Hp positives.