幽门螺杆菌相关消化道溃疡患者配偶感染危险因素

Prevalence of infection in spouses of patients with Helicobacter pylori-related digestive tract ulcer and risk factors

目的探讨幽门螺杆菌(Hp)相关消化道溃疡患者配偶幽门螺杆菌感染危险因素,并建立预测模型。方法选择重庆两江新区第一人民医院消化内科2018年6月-2021年6月消化性溃疡伴Hp阳性患者为研究对象,根据配偶13C尿素呼气试验检查结果,将其分为配偶阳性组(n=80)和配偶阴性组(n=64)。患者在就诊时以调查问卷形式对患者或配偶一般资料进行统计,对相关条目不理解者进行讲解和培训,统计条目包括配偶年龄、性别、吸烟、饮酒、学历、家庭月收入、是否混用牙缸/牙具、是否经常外出聚餐、合并消化道溃疡,统计完成后由双人录入数据,并核查数据准确性。以单因素分析和二元Logistic回归分析建立预测模型,Hosmer-Lemeshow检验受试者工作特征(ROC)曲线检验模型应用价值。结果两组饮酒、同居时间、是否混用牙缸牙具、合并消化道溃疡情况比较差异有统计学意义(P<0.05);二元Logistic回归分析结果显示饮酒、同居时间≥10年、混用牙缸/牙具、合并消化道溃疡均是消化性溃疡伴Hp阳性患者配偶Hp阳性的独立危险因素(P<0.05);预测模型综合检验P<0.001,Hosmer-Lemeshow检验结果P=0.350,表明预测模型与实际情况有较好的拟合程度。进一步ROC分析结果显示,预测模型预测消化性溃疡伴Hp阳性患者配偶Hp曲线下面积为0.895(95%CI:0.833~0.940),标准误为0.026,当预测模型得分为3.26分时获得最佳截断值,此时敏感度为81.25%,特异度为82.81%。结论Hp相关消化道溃疡患者配偶Hp阳性与多种因素均相关,建立预测模型预测价值较高,具有临床应用价值。

OBJECTIVE To explore the risk factors for Helicobacter pylori(HP)infection in spouses of patients with Hp-related peptic ulcer and to establish a predictive model.METHODS Patients with peptic ulcer and Hp infection in the department of gastroenterology of the First People′s Hospital of Chongqing Liangjiang New Area from Jun 2018 to Jun 2021 were enrolled as the research subjects.According to the results of the~(13)C urea breath test of their spouses,they were divided into the spouse-positive group(n=80)and spouse-negative group(n=64).When the patient visited a doctor,the general data of the patients and their spouses were collected in the form of questionnaire as they first visited the doctor,and those who did not understand the relevant items were explained and trained.The statistical items included the spouses′age,gender,smoking,alcohol consumption,educational background,monthly household income,mixed use of dental cylinder/dental gear,frequency of take-out meal consumption and combination of digestive tract ulcers.After the data were collected,two people would enter the data and check the accuracy of the data.The predictive model was established by univariate analysis and binary logistic regression analysis,and Hosmer-Lemeshow test Receiver operating characteristic curve(ROC)test was used to analysis the application value of the model.RESULTS There were significant differences in alcohol consumption,cohabitation time,mixed use of dental cylinder/dental gear and combination of digestive ulcers(P<0.05).Binary logistic regression analysis showed that drinking,cohabitation time≥10 years,mixed use of dental cylinders/dental gear,and peptic ulcers were all independent risk factors for the Hp-positive infection in spouses of patients with Hp-positive peptic ulcer(P<0.05).The comprehensive test of the prediction model was P<0.001,and the result of Hosmer-Lemeshow test was P=0.350,indicating that the prediction model had a better degree of fitting with the actual situation.The ROC analysis further showed that the AUC of the prediction model for the prediction of Hp positive infection in spouse of patients with Hp-positive peptic ulcer was 0.895(95%CI:0.833-0.940),with the standard error of 0.026.The optimal cut-off value was obtained when the prediction model score was 3.26,with the sensitivity and specificity of 81.25%and 82.81%,respectively.CONCLUSION Hp positive in spouses of patients with HP-related digestive tract ulcers is correlated with many factors,so the establishment of a prediction model shows high predictive value and clinical application value.