南通地区体检人群幽门螺杆菌感染状况及其影响因素的单中心回顾性研究
| 作 者：陶嘉, 张鑫洋, 瞿越, 阙纤沣, 蒯小玲 |
| 单 位：南通大学附属医院消化内科 |
| 基金项目：国家自然科学基金 |
| 摘 要： |
| 背景：幽门螺杆菌（Hp）是慢性活动性胃炎、消化性溃疡的主要病因，且与胃癌发生有关。Hp感染在胃癌防控中的价值一直是全球医学和微生物学领域的重要研究热点。目的：探讨南通地区体检人群的Hp感染状况，并分析其影响因素。方法：纳入2021年1月—2023年8月在南通大学附属医院行Hp感染检测的体检人群7 294名。采用13C-尿素呼气试验检测Hp感染状况，收集体检人群的基本信息，并分析其与Hp感染的相关性。以多因素Logistic回归分析筛选Hp感染的影响因素。采用新型胃癌筛查评分系统对体检人群进行胃癌风险分层，并随访胃癌高危人群的胃镜检查结果。结果：在7 294名体检人群中，Hp感染率为39.1%。Hp感染与年龄、空腹血糖、胃泌素17（G-17）、胃蛋白酶原（PG）Ⅰ、PGⅡ、PGⅠ/PGⅡ比值（PGR）相关（P均<0.05）。多因素Logistic回归分析显示年龄（OR=0.992，95% CI: 0.985~0.998）、体质指数（OR=1.041，95% CI: 1.019~1.064）、舒张压（OR=1.015，95% CI: 1.007~1.022）、空腹血糖（OR=1.080，95% CI: 1.026~1.136）、G-17（OR=1.032，95% CI: 1.023~1.042）、PGⅠ（OR=1.051，95% CI: 1.043~1.059）、PGⅡ（OR=0.941，95% CI: 0.904~0.980）、PGR（OR=0.393，95% CI: 0.357~0.432）为Hp感染的影响因素（P均<0.05）。根据新型胃癌筛查评分系统，胃癌高危人群1 106名（15.2%），其中288名行胃镜检查，病变检出率为28.1%，包括75例萎缩/肠化生、3例低级别上皮内瘤变、3例进展期胃癌。Hp感染阴性人群的病变检出率低于Hp感染阳性人群，但差异无统计学意义（25.5%对29.8%，P>0.05）。结论：南通地区体检人群的Hp感染率为39.1%，年龄、体质指数、舒张压、空腹血糖、G-17、PGⅠ、PGⅡ、PGR为Hp感染的影响因素。新型胃癌筛查评分系统筛查出的胃癌高危人群应积极进行胃镜检查。 |
| 关键词：幽门螺杆菌；胃蛋白酶原类；胃泌素类；胃肿瘤 |
Helicobacter pylori Infection Status and Influencing Factors in A Physical Examination Population in Nantong: A Single-center Retrospective Study
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| Abstract: |
| Background: Helicobacter pylori (Hp) is the primary etiological factor of chronic active gastritis and peptic ulcer, and is also associated with the development of gastric cancer. The value of Hp infection in gastric cancer prevention and control remains a crucial research hotspot in the global fields of medicine and microbiology. Aims: To investigate the status of Hp infection in a physical examination population in Nantong and its influencing factors. Methods: A total of 7 294 individuals who underwent physical examination (including Hp infection detection) at the Affiliated Hospital of Nantong University from January 2021 to August 2023 were enrolled. ¹³C-urea breath test was used to determine Hp infection status. Baseline information of the individuals was collected to analyze their correlations with Hp infection. Multivariate Logistic regression analysis was performed to identify the influencing factors of Hp infection. The novel gastric cancer screening scoring system was adopted for gastric cancer risk stratification in this physical examination population, and the gastroscopic findings in high-risk individuals for gastric cancer were followed up. Results: Among the 7 294 individuals, the prevalence of Hp infection was 39.1%. Hp infection was correlated with age, fasting blood glucose, gastrin-17 (G-17), pepsinogen (PG)Ⅰ, PGⅡ, and PGⅠ/PGⅡ ratio (PGR) (all P<0.05). Multivariate Logistic regression analysis revealed that age (OR=0.992, 95% CI: 0.985-0.998), body mass index (OR=1.041, 95% CI: 1.019-1.064), diastolic blood pressure (OR=1.015, 95% CI: 1.007-1.022), fasting blood glucose (OR=1.080, 95% CI: 1.026-1.136), G-17 (OR=1.032, 95% CI: 1.023-1.042), PGⅠ (OR=1.051, 95% CI: 1.043-1.059), PGⅡ (OR=0.941, 95% CI: 0.904-0.980), and PGR (OR=0.393, 95% CI: 0.357-0.432) were influencing factors of Hp infection (all P<0.05). According to the novel gastric cancer screening scoring system, 1 106 individuals (15.2%) were identified as high-risk for gastric cancer. Among them, 288 individuals underwent gastroscopy, with a lesion detection rate of 28.1%, including 75 cases of atrophy/intestinal metaplasia, 3 cases of low-grade intraepithelial neoplasia, and 3 cases of advanced gastric cancer. The lesion detection rate in Hp-negative individuals was lower than that in Hp-positive individuals, however, no significant difference was found (25.5% vs. 29.8%, P>0.05). Conclusions: The prevalence of Hp infection among physical examination population in Nantong is 39.1%, and age, body mass index, diastolic blood pressure, fasting blood glucose, G-17, PGⅠ, PGⅡ, and PGR are the influencing factors of Hp infection. Individuals at high risk for gastric cancer identified by the novel gastric cancer screening scoring system should be actively recommended for gastroscopy. |
| Keywords: Helicobacter pylori; Pepsinogens; Gastrins; Stomach Neoplasms |
| 投稿时间：2025-04-23 |
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