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...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.展开更多
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 centre...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.展开更多
Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication t...Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication therapy.Only highly accurate tests should be used in clinical practice,and the sensitivity and specificity of an adequate test should exceed 90%.The choice of tests should take into account clinical circumstances,the likelihood ratio of positive and negative tests,the cost-effectiveness of the testing strategy and the availability of the tests.This review concerns some of the most recent developments in diagnostic methods of H.pylori infection,namely the contribution of novel endoscopic evaluation methodologies for the diagnosis of H.pylori infection,such as magnifying endoscopy techniques and chromoendoscopy.In addition,the diagnostic contribution of histology and the urea breath test was explored recently in specific clinical settings and patient groups.Recent studies recommend enhancing the number of biopsy fragments for the rapid urease test.Bacterial culture from the gastric biopsy is the gold standard technique,and is recommended for antibiotic susceptibility test.Serology is used for initial screening and the stool antigen test is particularly used when the urea breath test is not available,while molecular methods have gained attention mostly for detecting antibiotic resistance.展开更多
To evaluate vital signs and body indices in Helicobacter pylori(H.pylori)positive and negative persons.A total of 22 centres entered the study.They were spread over the whole country,corresponding well to the geograph...To evaluate vital signs and body indices in Helicobacter pylori(H.pylori)positive and negative persons.A total of 22 centres entered the study.They were spread over the whole country,corresponding well to the geographical distribution of the Czech population.A total of 1818 subjects(aged 5-98 years)took part in the study,randomly selected out of 38147 subjects.H.pylori infection was investigated by means of a 13Curea breath test.Data on height,weight,systolic and diastolic blood pressure and heart rate were collected at the clinics of general practitioners.The overall prevalence of H.pylori infection was 30.4%(402/1321)in adults(≥18 year-old)and 5.2%(26/497)in children and adolescents(≤17 year-old).Once adjusted for age and gender,only a difference in body mass index remained statistically significant with H.pylori positive adults showing an increase of 0.6 kg/m2 in body mass index.Once adjusted for age and gender,we found a difference in height between H.pylori positive and H.pylori negative children and adolescents.On further adjustment for place of residence,this difference became statistically significant,with H.pylori positive children and adolescents being on average 3.5 cm shorter.H.pylori positive adults were significantly older compared to H.pylori negative subjects.Once adjusted for age and gender,H.pylori infection had no impact on body weight,body mass index and vital signs either in adults or children and adolescents.Chronic H.pylori infection appeared to be associated with short stature in children.H.pylori infection did not influence blood pressure,body weight and body mass index either in adults or children and adolescents.展开更多
AIM: To study the diagnosis of He/icobacterpy/ori(H pylori) infection through the determination of serum levels of anti-H pylori IgG and IgA antibodies, and the levels of anti- H pylori IgA antibodies in duodenal flui...AIM: To study the diagnosis of He/icobacterpy/ori(H pylori) infection through the determination of serum levels of anti-H pylori IgG and IgA antibodies, and the levels of anti- H pylori IgA antibodies in duodenal fluid. METHODS: Data were collected from 93 patients submitted to upper digestive endoscopy due to dyspeptic symptoms. The patients were either negative (group A) or positive (group B) to Hpyloriby means of both histological detection and urease tests. Before endoscopy, peripheral blood was collected for the investigation of anti-H pylori IgG and IgA antibodies. To perform the urease test, biopsies were obtained from the gastric antrum. For the histological evaluation, biopsies were collected from the gastric antrum (greater and lesser curvatures) and the gastric body. Following this, duodenal fluid was collected from the first and second portions of the duodenum. For the serological assaying of anti-Hpy/oriIgG and IgA, and anti-Hpy/oriIgA in duodenal fluids, the ELISA method was utilized. RESULTS: The concentration of serum IgG showed sensitivity of 64.0%, specificity of 83.7%, positive predictive value of 82.0%, negative predictive value of 66.6% and accuracy of 73.1% for the diagnosis of H pyloriinfection. For the same purpose, serum IgA showed sensitivity of 72.0%, specificity of 65.9%, positive predictive value of 72.0%, negative predictive value of 67.4% and accuracy of 69.8%. If the serological tests were considered together, i.e. when both were positive or negative, the accuracy was 80.0%, sensitivity was 86.6%, specificity was 74.2%, positive predictive value was 74.2% and negative predictive value was 86.6%. When values obtained in the test for detecting IgA in the duodenal fluid were analyzed, no significant difference (P=0.43) was observed between the values obtained from patients with or without Hpyloriinfection. CONCLUSION: The results of serum IgG and IgA tests for H pylori detection when used simultaneously, are more efficient in accuracy, sensitivity and negative predictive value, than those when used alone. The concentration of IgA antibodies in duodenal fluid is not useful in identifying patients with or without H pylori.展开更多
文摘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.
基金Supported by Research Project PRVOUK P37-08 from Faculty of Medicine at Hradec Králové,Charles University in Praha,Czech Republic
文摘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.
文摘Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication therapy.Only highly accurate tests should be used in clinical practice,and the sensitivity and specificity of an adequate test should exceed 90%.The choice of tests should take into account clinical circumstances,the likelihood ratio of positive and negative tests,the cost-effectiveness of the testing strategy and the availability of the tests.This review concerns some of the most recent developments in diagnostic methods of H.pylori infection,namely the contribution of novel endoscopic evaluation methodologies for the diagnosis of H.pylori infection,such as magnifying endoscopy techniques and chromoendoscopy.In addition,the diagnostic contribution of histology and the urea breath test was explored recently in specific clinical settings and patient groups.Recent studies recommend enhancing the number of biopsy fragments for the rapid urease test.Bacterial culture from the gastric biopsy is the gold standard technique,and is recommended for antibiotic susceptibility test.Serology is used for initial screening and the stool antigen test is particularly used when the urea breath test is not available,while molecular methods have gained attention mostly for detecting antibiotic resistance.
基金Supported by Research project PRVOUK P37-08(from Charles University in Praha,Faculty of Medicine at Hradec Kralove,Czech Republic)
文摘To evaluate vital signs and body indices in Helicobacter pylori(H.pylori)positive and negative persons.A total of 22 centres entered the study.They were spread over the whole country,corresponding well to the geographical distribution of the Czech population.A total of 1818 subjects(aged 5-98 years)took part in the study,randomly selected out of 38147 subjects.H.pylori infection was investigated by means of a 13Curea breath test.Data on height,weight,systolic and diastolic blood pressure and heart rate were collected at the clinics of general practitioners.The overall prevalence of H.pylori infection was 30.4%(402/1321)in adults(≥18 year-old)and 5.2%(26/497)in children and adolescents(≤17 year-old).Once adjusted for age and gender,only a difference in body mass index remained statistically significant with H.pylori positive adults showing an increase of 0.6 kg/m2 in body mass index.Once adjusted for age and gender,we found a difference in height between H.pylori positive and H.pylori negative children and adolescents.On further adjustment for place of residence,this difference became statistically significant,with H.pylori positive children and adolescents being on average 3.5 cm shorter.H.pylori positive adults were significantly older compared to H.pylori negative subjects.Once adjusted for age and gender,H.pylori infection had no impact on body weight,body mass index and vital signs either in adults or children and adolescents.Chronic H.pylori infection appeared to be associated with short stature in children.H.pylori infection did not influence blood pressure,body weight and body mass index either in adults or children and adolescents.
文摘AIM: To study the diagnosis of He/icobacterpy/ori(H pylori) infection through the determination of serum levels of anti-H pylori IgG and IgA antibodies, and the levels of anti- H pylori IgA antibodies in duodenal fluid. METHODS: Data were collected from 93 patients submitted to upper digestive endoscopy due to dyspeptic symptoms. The patients were either negative (group A) or positive (group B) to Hpyloriby means of both histological detection and urease tests. Before endoscopy, peripheral blood was collected for the investigation of anti-H pylori IgG and IgA antibodies. To perform the urease test, biopsies were obtained from the gastric antrum. For the histological evaluation, biopsies were collected from the gastric antrum (greater and lesser curvatures) and the gastric body. Following this, duodenal fluid was collected from the first and second portions of the duodenum. For the serological assaying of anti-Hpy/oriIgG and IgA, and anti-Hpy/oriIgA in duodenal fluids, the ELISA method was utilized. RESULTS: The concentration of serum IgG showed sensitivity of 64.0%, specificity of 83.7%, positive predictive value of 82.0%, negative predictive value of 66.6% and accuracy of 73.1% for the diagnosis of H pyloriinfection. For the same purpose, serum IgA showed sensitivity of 72.0%, specificity of 65.9%, positive predictive value of 72.0%, negative predictive value of 67.4% and accuracy of 69.8%. If the serological tests were considered together, i.e. when both were positive or negative, the accuracy was 80.0%, sensitivity was 86.6%, specificity was 74.2%, positive predictive value was 74.2% and negative predictive value was 86.6%. When values obtained in the test for detecting IgA in the duodenal fluid were analyzed, no significant difference (P=0.43) was observed between the values obtained from patients with or without Hpyloriinfection. CONCLUSION: The results of serum IgG and IgA tests for H pylori detection when used simultaneously, are more efficient in accuracy, sensitivity and negative predictive value, than those when used alone. The concentration of IgA antibodies in duodenal fluid is not useful in identifying patients with or without H pylori.