我国西南地区藏汉家庭幽门螺杆菌感染状况的对比研究

Comparative Study of Helicobacter pylori Infection Status in Tibetan and Han Chinese Families in Southwest China

背景:目前尚无不同民族基于家庭的幽门螺杆菌(Hp)感染现状对比研究。目的:以家庭为单位,探索藏族和汉族家庭的Hp感染状况。方法:本研究为多中心横断面研究,采用方便抽样法,于2021年8月—2023年5月纳入重庆市50户汉族家庭(共计169人)和雅安市50户藏族家庭(共计155人),进行Hp相关因素问卷调查,并以13C-尿素呼气试验检测Hp感染情况。结果:我国西南地区藏族个体和家庭的Hp感染率分别为47.1%和80.0%,显著高于汉族个体和家庭的27.8%和58.0%(P均<0.05)。Hp感染个体并不是均匀分布在人群中,汉族家庭中32.0%(16/50)有2人及以上Hp阳性,藏族家庭该比例为44.0%(22/50),这些家庭分别集中了72.3%(34/47)的汉族感染者和75.3%(55/73)的藏族感染者。16.0%(8/50)的藏族家庭所有成员均为Hp阳性,汉族家庭该比例仅为2.0%(1/50)。汉族居民既往接受过Hp检测和治疗的比例分别为31.4%和13.6%,显著高于藏族居民的0.6%和0.6%(P均<0.05)。藏族个体和家庭在教育程度、生活习惯、经济和卫生条件方面均落后于汉族(P均<0.05)。结论:Hp感染的传播具有家庭聚集性特征。藏族居民个体和家庭的Hp现症感染率明显高于汉族,且既往接受过Hp诊治的比例更低。

Background:Till now,there is no family⁃based comparative study on current status of Helicobacter pylori(Hp)infection in different ethnic groups.Aims:To investigate the status of Hp infection in Tibetan and Han Chinese families at the household level.Methods:A multicentre cross⁃sectional survey was conducted in southwest China by convenient sampling method from August 2021 to May 2023.A questionnaire was used to collect the Hp⁃associated factors in 50 Han Chinese families(169 individuals)in Chongqing Municipality and 50 Tibetan families(155 individuals)in Ya'an,Sichuan Province.13C⁃urea breath test was used to detect Hp infection.Results:The individual and household Hp infection rates of the Tibetan population in southwest China were significantly higher than those of the Han Chinese population(47.1%vs.27.8%and 80.0%vs.58.0%,all P<0.05).Hp infection was concentrated in certain family groups rather than being evenly distributed in the population.In Han Chinese population,32.0%(16/50)of the families had≥2 infected members,and in Tibetan population,44.0%(22/50)of the families had≥2 infected members.72.3%(34/47)of the infected Han Chinese and 75.3%(55/73)of the infected Tibetans were members of these certain families.In 16.0%(8/50)Tibetan families,all members were infected;while in Han Chinese families,this proportion was only 2.0%(1/50).31.4%of the Han Chinese received Hp detection previously,and 13.6%underwent eradication therapy,both were significantly higher than those of the Tibetans(0.6%and 0.6%,all P<0.05).The education level,living habits,economic conditions,as well as personal and household hygiene of Tibetan population were all inferior to those of Han Chinese(all P<0.05).Conclusions:Transmission of Hp infection is characterized by family aggregation.The current infection rates of individuals and families in Tibetan population are significantly higher than those in Han Chinese.Test⁃and⁃treat strategy for Hp infection should be promoted in Tibetans.