昆山市农村人群幽门螺杆菌感染情况调查及其影响因素

Current status and influencing factors of Helicobacter pylori infection in rural population of Kunshan city

目的 了解昆山市农村户籍人口中幽门螺杆菌(Helicobacter pylori,H.pylori)感染情况及其影响因素,为开展H.pylori防治提供依据。方法 采用横断面调查研究,随机整群抽取锦溪镇8个村(社区)30~70岁户籍人口中符合纳排标准的人群,采用14C尿素呼气试验检测其H.pylori感染情况。采用结构性问卷面对面调查研究对象的人口学特征和生活方式等因素;通过单因素和多元logistic回归分析人口学特征和生活方式等因素与H.pylori感染的关联性。结果共纳入调查对象8 722名,H.pylori的总感染率为44.58%,男性感染率为42.50%(1 657/3 898),女性感染率为46.27%(2 232/4 824)。单因素分析结果显示,不同年龄段、性别、婚姻状况、BMI情况、饭前洗手和吸烟情况人群H.pylori感染率的差异均有统计学意义(P值均<0.05)。logistic回归分析显示,与<40岁年龄组相比,40~49岁、50~59岁和≥60岁人群感染H.pylori的风险分别是<40岁年龄组感染H.pylori的1.613倍(95%CI为1.281~2.031,P<0.001)、1.575倍(95%CI为1.263~1.965,P<0.001)和1.307倍(95%CI为1.047~1.630,P=0.018)。女性感染H.pylori的风险是男性感染H.pylori的1.132倍(95%CI为1.003~1.277,P=0.045)。超重和肥胖人群感染H.pylori的风险是偏瘦人群的1.291 5倍(95%CI为1.026~1.62,P=0.030)。结论 昆山地区农村户籍人口H.pylori感染率居于全国平均水平,H.pylori感染与年龄、性别和BMI有关。

Objective To investigate the infection of Helicobacter pylori(H.pylori)and its influencing factors in rural registered population in Kunshan,so as to provide the basis for the prevention and control of H.pylori.Methods In this cross-sectional study,the registered residence of 30-70 years old from 8 villages(communities)in Jinxi Town,Kunshan city,who met the inclusive and exclusive criteria were randomly selected by cluster sampling.The infection of H.pylori was detected by 14 C-urea breath test.Demographic and lifestyle factors were collected by trained interviewers with face-to-face structured questionnaire.Univariate and multivariate logistic regression analyses were used to explore the associations between demographic and lifestyle factors and H.pylori infection.Results A total of 8722 participants were enrolled in this study.The prevalence of H.pylori was 44.58%among the participants.The prevalence of H.pylori was 42.50%(1657/3898)in males and 46.27%(2232/4824)in females.Univariate analysis showed that there were statistically significant differences in the H.pylori infection rate among populations of different ages,genders,marital status,BMI,washing hands before meals,and smoking(P<0.05).Logistic regression analysis showed that age,gender,and BMI were the main influencing factors for H.pylori infection in rural populations in Kunshan city.The risks of H.pylori infection in adults aged 40-49 years,50-59 years and≥60 years were 1.613 times(95%CI:1.281-2.031,P<0.001),1.575 times(95%CI:1.263-1.965,P<0.001)and 1.307 times(95%CI:1.047-1.630,P=0.018)than those in adults aged less than 40 years.The risk of H.pylori infection in females was 1.132 times higher than that in males(95%CI:1.003-1.277,P=0.045).The risk of H.pylori infection in overweight/obese individuals was 1.291 times higher than that in lean individuals(95%CI:1.026-1.625,P=0.030).Conclusion The infection rate of H.pylori among rural registered population in Kunshan reaches the national average.Operational intervention strategies should be developed for people of different ages,genders and BMI.