慢性胃炎Hp感染状况、菌株分型与胃黏膜病变的相关性研究

Correlation between Helicobacter pylori infection status,strain typing,and gastric mucosal lesions in chronic gastritis

目的探讨慢性胃炎幽门螺杆菌(Hp)感染状况、菌株分型及其与胃黏膜病变的相关性。方法回顾性分析西安国际医学中心医院、乌海市人民医院、铜川市人民医院2022年1—7月诊治的慢性胃炎患者11500例的病历资料,分析患者Hp检测结果、菌株分型,Hp感染患者的基本情况、胃黏膜病变情况。以Pearson相关分析菌株类型与胃黏膜病变的相关性,以logistic回归分析影响慢性胃炎Hp感染的因素。结果Hp感染7549例(65.65%)。家庭人数≥3人、农民和工人、经常喝生水、经常吃腌制食品、不喝茶、年龄≥50岁、病程≥2年等患者的Hp阳性率分别高于家庭人数<3人、干部、不经常喝生水、不吃腌制食品、喝茶、年龄<50岁、病程<2年的患者(均P<0.05)。患者主要感染Hp高毒力Ⅰ型菌株(55.65%)。不同菌株类型患者的无上皮内瘤、低级别上皮内瘤变、高级别上皮内瘤变、胃浸润癌例数差异均有统计学意义(χ^(2)=40.33、7.65、11.39、54.89,均P<0.05);经Pearson相关性分析,无上皮内瘤与菌株类型存在显著的相关性(r=0.539,P<0.001);经logistic回归分析,年龄≥50岁、病程≥2年等均是影响慢性胃炎Hp感染的独立影响因素(P=0.005、0.002)。结论家庭成员多、农民和工人、经常喝生水及食用腌制食品者可增高Hp感染率,喝茶可降低Hp感染率。慢性胃炎常易感染Hp高毒力Ⅰ型菌株。无上皮内瘤与菌株类型呈正相关。年龄≥50岁、病程≥2年是慢性胃炎Hp感染的独立影响因素。

ObjectiveTo investigate Helicobacter pylori(Hp)infection status,strain typing,and their correlations with gastric mucosal lesions in chronic gastritis.MethodsA retrospective analysis was conducted on the medical records of 11500 patients with chronic gastritis who received treatment at Xi'an International Medical Center Hospital,People's Hospital of Wuhai,and People's Hospital of Tongchuan from January to July 2022.Hp test results,strain typing,and the basic characteristics and gastric mucosal lesions of Hp-infected patients were determined.Pearson correlation analysis was performed to assess the correlation between strain types and gastric mucosal lesions.Logistic regression analysis was performed to identify factors influencing Hp infection in patients with chronic gastritis.ResultsA total of 7549 cases of Hp infection were identified(65.65%).Patients with more than three family members,farmers and workers,those who frequently drank raw water,consumed pickled foods,did not drink tea,were aged 50 years or older,or had a disease duration of 2 years or more had a higher Hp-positive rate compared with those with fewer than three family members,government officials,those who infrequently drank raw water,did not consume pickled foods,drank tea,were younger than 50 years,or had a disease duration of less than 2 years(all P<0.05).The majority of infected patients harbored the highly virulent type I Hp strains(55.65%).The numbers of cases of non-epithelial neoplasia,low-grade intraepithelial neoplasia,high-grade intraepithelial neoplasia,and gastric infiltrating carcinoma were significantly different among different strain types(χ^(2)=40.33,7.65,11.39,54.89,all P<0.05).ConclusionA higher number of family members,being a farmer or a worker,frequently drinking raw water,and consuming pickled foods are associated with an increased rate of Hp infection,while drinking tea is linked to a reduced infection rate.Patients with chronic gastritis are often infected with highly virulent type I Hp strain.There is a positive correlation between non-epithelial neoplasia and strain type.Age≥50 years and disease duration≥2 years are independent factors influencing Hp infection in chronic gastritis.