北京地区健康体检者幽门螺杆菌感染情况及其毒力因子特征分析

Analysis of Helicobacter pylori infection and its virulence factors among physical examinees in Beijing

目的分析体检者幽门螺杆菌感染情况及其毒力因子特征,为幽门螺杆菌防治工作提供借鉴信息。方法以2022年1—12月于北京某医院体检中心进行健康体检的北京地区居民为研究对象进行问卷调查,收集其尿素^(13)C呼气试验和血生化指标,对尿素^(13)C呼气试验阳性患者采用蛋白质芯片法检测毒力因子情况,采用描述性分析方法对体检者幽门螺杆菌感染情况及其毒力因子特征进行分析,通过单、多因素分析方法分析幽门螺杆菌感染的影响因素。结果最终获得2746例有效调查对象,男女性别比1.05∶1(1405/1341),年龄21~76岁,以40~49岁者占比最高(28.77%,790/2746)。幽门螺杆菌感染率为33.25%(913/2746)。多因素logistic回归分析提示饮酒(OR=1.530)、在外就餐(OR=2.052)、摄入腌制食品(OR=1.822)、家庭成员幽门螺杆菌感染史(OR=3.904)、空腹血糖异常(OR=1.980)、同型半胱氨酸异常(OR=1.766)、血脂异常(OR=1.498)、幽门螺杆菌认知水平(OR=0.321)是幽门螺杆菌感染的影响因素。幽门螺杆菌感染毒力因子分型以血清中幽门螺杆菌细胞毒素相关蛋白A(CagA)抗体(+)、空泡毒素A(VacA)抗体(+)、尿素酶(Ure)抗体(+)表达者居多(39.54%)。结论北京地区健康体检者幽门螺杆菌感染率较高,其受到饮酒、在外就餐、摄入腌制食品、家庭成员幽门螺杆菌感染史、空腹血糖异常、同型半胱氨酸异常、血脂异常、幽门螺杆菌认知水平多种因素影响,且血清CagA抗体阳性表达居多,可针对感染现状及毒力因子特征采取有效干预措施,预防控制幽门螺杆菌感染及相关疾病的发生、发展。

Objective To analyze the Helicobacter pylori infection and its virulence factors among physical exam-inees and provide the reference information for prevention and treatment of Helicobacter pylori.Methods A questionnaire survey was conducted among residents in Beijing who underwent physical examination in a physical examination center of a Beijing hospital from January to December 2022.Urea^(13)C breath test results and blood biochemical indicators were col-lected.The virulence factors of patients with positive urea^(13)C breath test were detected by protein chip method.Descriptive analysis method was used to analyze the infection status and virulence factors of Helicobacter pylori among the physical ex-aminees.Univariate and multivariate analyses were used to analyze the influencing factors of Helicobacter pylori infection.Results A total of 2746 physical examinees were investigated,with a male to female ratio of 1.05:1(1405/1341),aged 21-76 years old,with the highest proportion of 40-49 years old 28.77%(790/2746)J.The infection rate of Helicobacter pylori was 33.25%(913/2746).Multivariate Logistic regression analysis showed that drinking(OR=1.530),eating out(OR=2.052),eating pickled food(OR=1.822),family history of Helicobacter pylori infection(OR=3.904),fasting blood glucose abnormality(OR=1.980),homocysteine abnormality(OR=1.766),dyslipidemia(OR=1.498),and cognitive level of Helicobacter pylori(OR=0.321)were influencing factors of Helicobacter pylori infection.The expression of Helico-bacter pylori cytotoxin-associated protein A(CagA)antibody(+),vacuolating cytotoxin A(VacA)antibody(+),and ure-ase(Ure)antibody(+)in serum was the most common type of virulence factors in Helicobacter pylori infection,accounting for 39.54%.ConclusionsThe infection rate of Helicobacter pylori among physical examinees is relatively high,which is affected by many factors such as drinking,eating out,eating pickled food,family history of Helicobacter pylori infection,abnormal fasting blood glucose,abnormal homocysteine,dyslipidemia,and cognitive level of Helicobacter pylori.In addition,the expression of serum CagA antibody(+)is in the majority.Effective intervention measures can be taken according to the infection status and virulence factor characteristics to prevent and control the occurrence and development of Helicobacter pylori infection and related diseases.