Epidemiological investigation of Helicobacter pylori infection in elderly people in Beijing

BACKGROUND The Helicobacter pylori(H.pylori)infection rate in China is approximately 50%.H.pylori is a pathogenic factor of peptic ulcer and chronic gastritis.In addition,H.pylori infection may also be associated with a variety of cardiovascular diseases in elderly people,such as arteriosclerosis,coronary heart disease,and cerebral infarction,having deleterious effect on their health.With the aging of the population,the disease characteristics of the elderly population have been increasingly valued by the whole society.We conducted an epidemiological survey of H.pylori infection among elderly people in Beijing to provide a basis for health management of H.pylori infection.AIM To understand the epidemiological characteristics of H.pylori infection in elderly people in Beijing.METHODS A total of 1090 elderly people aged more than 60 years from different parts of Beijing(urban and rural areas)were selected using the random cluster sampling method.Structured questionnaires were completed during home visits and the 13C-urea breath test was conducted for H.pylori detection.RESULTS The prevalence of H.pylori infection was 46.5%(507/1090).The infection rate in men was 51.8%,which was significantly higher than that in women(42.5%;P<0.05).The H.pylori infection rate in illiterate people was significantly higher than that in literate persons(53.5%vs 44.8%,P<0.05).The total infection rate of H.pylori gradually increased with age and the difference was statistically significant(P<0.01).The H.pylori infection rate in smokers was significantly higher than that in non-smokers and those who had quit smoking(P<0.05).CONCLUSION The prevalence of H.pylori infection among elderly people is 46.5%and the infection rate gradually increases with age.Sex,education level,age,and smoking were determined to be H.pylori infection risk factors.The relationship of H.pylori infection with region,occupation,drinking,and diet structure needs to be further studied.

Effect of posture on ^(13)C-urea breath test in partial gastrectomy patients

AIM: To investigate whether posture affects the accuracy of 13C-urea breath test(13C-UBT) for Helicobacter pylori(H. pylori) detection in partial gastrectomy patients. METHODS: We studied 156 consecutive residual stomach patients, including 76 with H. pylori infection(infection group) and 80 without H. pylori infection(control group). H. pylori infection was confirmed if both the rapid urease test and histology were positive during gastroscopy. The two groups were divided into four subgroups according to patients' posture during the 13C-UBT: subgroup A, sitting position; subgroup B, supine position; subgroup C, right lateral recumbent position; and subgroup D, left lateral recumbent position. Each subject underwent the following modified 13C-UBT: 75 mg of 13C-urea(powder) in 100 m L of citric acid solution was administered, and a mouth wash was performed immediately; breath samples were then collected at baseline and at 5-min intervals up to 30 min while the position was maintained. Seven breathsamples were collected for each subject. The cutoff value was 2.0‰.RESULTS: The mean delta over baseline(DOB) values in the subgroups of the infection group were similar at 5 min(P > 0.05) and significantly higher than those in the corresponding control subgroups at all time points(P < 0.01). In the infection group, the mean DOB values in subgroup A were higher than those in other subgroups within 10 min and peaked at the 10-min point(12.4‰± 2.4‰). The values in subgroups B and C both reached their peaks at 15 min(B, 13.9‰± 1.5‰; C, 12.2‰± 1.7‰) and then decreased gradually until the 30-min point. In subgroup D, the value peaked at 20 min(14.7‰± 1.7‰). Significant differences were found between the values in subgroups D and B at both 25 min(t = 2.093, P = 0.043) and 30 min(t = 2.141, P = 0.039). At 30 min, the value in subgroup D was also significantly different from those in subgroups A and C(D vs C: t = 6.325, P = 0.000; D vs A: t = 5.912, P = 0.000). The mean DOB values of subjects with Billroth Ⅰ anastomosis were higher than those of subjects with Billroth Ⅱ anastomosis irrespectively of the detection time and posture(P > 0.05).CONCLUSION: Utilization of the left lateral recumbent position during the procedure and when collecting the last breath sample may improve the diagnostic accuracy of the 13C-UBT in partial gastrectomy patients.

^(13)C-UBT检测幽门螺杆菌4871例临床分析

目的:初步探讨幽门螺杆菌相关疾病病因及感染率。方法:利用13C呼气试验检测幽门螺杆菌感染率。结果:13C呼气试验检测幽门螺杆菌具有简单方便、无创伤性、无放射性、可反复、先进、即时、灵敏、特异、快速特点。结论:13C呼气试验值得临床推广。

山东临朐县农村幽门螺杆菌感染的初步调查

采用１３Ｃ－尿素呼气试验方法对山东临朐县４０～６９岁２１８例村民进行了幽门螺杆菌（ＨＰ）感染的初步流行病学调查，并将此结果与胃镜下的病理变化作了比较。结果发现，总ＨＰ感染率为７１．１０％，肾性为６９．４９％，女性为７３．００％。重度萎缩性胃炎患者ＨＰ感染率显著高于轻度萎缩性胃炎患者（Ｐ＜０．０５），ＨＰ阳性者自觉胃部症状发生率高于ＨＰ阴性组。

兰州市健康体检人群幽门螺杆菌感染情况调查

背景:幽门螺杆菌(Hp)感染与消化性溃疡、胃癌等多种疾病的发生、发展密切相关。我国是Hp感染高发国,平均现症感染率为55%。目的:了解兰州市健康人群的Hp感染情况,为当地Hp感染的防治提供依据。方法:纳入2014年5月—2015年7月在兰州军区兰州总医院参加体检的健康成人3 239例,采用^(13)C-尿素呼气试验检测Hp感染情况。结果:3 239例受检者的Hp总体感染率为51.8%(1 679/3 239),其中男性和女性感染率分别为52.5%(1 197/2 279)和50.2%(482/960),总体和分年龄段男女性感染率差异均无统计学意义(P>0.05)。不同年龄段组间Hp感染率差异显著(P<0.05),41~60岁年龄段组感染率最高。结论:兰州市健康人群Hp现症感染率为51.8%,是一个不容忽视的公共卫生问题。Hp感染率随年龄增长而逐渐增高,与性别则无明显关联。

Significant decrease in prevalence ofHelicobacter pylori in the Czech Republic

AIM:To study possible decrease in prevalence of Helicobacter pylori(H.pylori) infection in the Czech Republic within a 10-year period.METHODS:A total of 22 centres entered the study.The catchment areas of these centres covered cities and towns with more than 20 000 inhabitants,smaller towns(≤ 20 000 inhabitants) with surrounding villages and rural areas,and were spread over the whole country,corresponding well to the geographical distribution of the Czech population.A total of 1 837 subjects(aged 5-98 years) took part in the study,randomly selected out of 38 147 people from the general population.H.pylori infection was investigated by means of a 13 C-urea breath test.Breath samples in duplicates were analysed using isotope ratio mass spectrometry.The cut-off point was 3.5.Social and demographic characteristics were based on data from self-completed questionnaires.RESULTS:The overall prevalence of H.pylori infection was 23.5%(430/1826),and 4.8%(20/420) in children aged 15 or less.There was no statistically significant difference in prevalence between males(24.3%;208/857) and females(22.9%,222/969,P = 0.494).H.pylori infection was strongly associated with higher age,among subjects aged 55+ years,prevalence of H.pylori infection was 39.8%(252/633,P < 0.001).The highest prevalence of H.pylori infection was found among persons aged 55-64 years(43.9%,97/221) and 75+ years(37.9%,58/153).Among study subjects aged 15+ years,prevalence of H.pylori infection was significantly increased in those with lowest education(odds risk 3.19,95% CI 1.87-5.47).Compared to never married(14.1%),the prevalence of H.pylori infection was statistically significantly higher among married(35.4%,246/694,P < 0.001),divorced(36.8%,49/133,P < 0.001) and widowed study subjects(40.2%,45/112,P < 0.001),both in minimally and fully adjusted analysis.There was no significant difference in the prevalence of H.pylori infection between married and widowed subjects(35.4%,246/694 vs 40.2%,45/112,P = 0.389).There was little variation in smoking prevalence across categories of smoking and there was no evidence of an increased risk ofH.pylori infection among current or past smokers in our data(odds risk 1.04 with 95% CI 0.78-1.40 for current smokers;odds ratio 0.83 with 95% CI 0.60-1.16 for former smokers).The current prevalence of H.pylori in 2011 was significantly lower compared to the prevalence reported from identical geographical areas in 2001(23.5%vs 41.7%,P < 0.001).CONCLUSION:The overall prevalence of H.pylori infection in the general population has fallen substantially in the Czech Republic over the past 10 years.