青海地区成年人不同年龄段Hp感染与胃部病变的临床研究

Clinical Study of Hp Infection and Gastric Lesions in Adults of Different Ages in Qinghai

摘要: 目的：研究青海地区成年人不同年龄段胃病患者的Hp感染情况，并分析年龄与Hp感染、年龄与胃病、Hp感染与胃病的关系，为青海地区Hp感染相关性胃病的诊治提供临床依据。方法：选取2019年10月至2020年11月，有消化道症状且持续3月以上，就诊于青海大学附属医院的成年患者1999例，所有患者均接受13C幽门螺杆菌尿素呼气试验检测和胃镜检查(含病理)，收集相关资料。使用SPSS26.0软件分析数据。结果：1) 1999例患者中，Hp阳性数1187例，阳性检出率为59.38%。男性Hp阳性数688例，阳性检出率为58.35%；女性Hp阳性数499人，阳性检出率为60.85%，平均年龄(51.0 ± 13.7)岁。18岁~29岁，30岁~39岁，40岁~49岁，50岁~59岁，60岁~69岁，70岁以上六个年龄段患者Hp阳性检出率分别为：73.25%，68.58%，66.15%，56.56%，51.69%，44.70%；随年龄增长，各年龄组间Hp阳性检出率逐渐下降，18岁~29岁患者Hp阳性检出率最高(73.25%)，70岁以上患者Hp阳性检出率最低(44.70%)；70岁以上的老年女性患者Hp阳性检出率高于相同年龄段的男性，差异具有显著统计学意义(P < 0.01)。2) 18岁~29岁年龄组患者慢性浅表性胃炎(34.4%)、十二指肠溃疡(19.1%)的检出率高于其他年龄组患者；60岁~69岁患者胃息肉(7.30%)的检出率高于其他年龄组；70岁以上患者慢性萎缩性胃炎(49.20%)、反流性食管炎(12.1%)、胃癌(8.30%)的检出率高于其他年龄组(P < 0.05)；胃溃疡、胆汁反流性胃炎、糜烂性胃炎、十二指肠球炎及其他胃部相关病变在各个年龄组间的差异无统计学意义(P > 0.05)。3) 胃病中十二指肠溃疡患者Hp的阳性检出率最高(77.78%)，胃癌患者的Hp阳性检出率最低(39.58%)，有显著统计学差异(P < 0.01)。结论：1) 青海地区有消化系统症状的成年患者中，不同年龄段的Hp阳性检出率有差异，随着年龄增长Hp阳性检出率呈逐渐下降的趋势。2) 中青年患者胃部病变以慢性浅表性胃炎、十二指肠溃疡为主；中老年患者胃部病变以慢性萎缩性胃炎、反流性食管炎、胃息肉及胃癌为主。3) 不同类型胃病中Hp的阳性检出率不同，其中，十二指肠溃疡患者的Hp检出率最高，胃癌患者的检出率最低。

Abstract: Objective: The objective is to study the Hp infection in adults with different ages of gastric disease in Qinghai, and analyze the relationship between age and Hp infection, age and gastric disease, Hp infection and gastric disease, and provide clinical evidence for the diagnosis and treatment of Hp infection-related gastric disease in Qinghai. Methods: Selected 1999 adult patients with gastrointestinal symptoms that lasted for more than 3 months and were treated at the Affiliated Hospital of Qinghai University from October 2019 to November 2020. All patients received 13C Helicobacter pylori urea breath test and gastroscopy (Including pathology), and relevant information was collected. Use SPSS26.0 software to analyze the data. Results: 1) Among the 1999 patients, 1187 were Hp positive, and the positive detection rate was 59.38%. There were 688 males with Hp positive, and the positive detection rate was 58.35%; 499 females with Hp positive, the positive detection rate was 60.85%, and the average age was 51.0 ± 13.7 years old. The positive detection rates of Hp in the six age groups 18~29 years old, 30~39 years old, 40~49 years old, 50~59 years old, 60~69 years old, and over 70 years old are: 73.25% and 68.58%, 66.15%, 56.56%, 51.69%, 44.70%; with the increase of age, the positive detection rate of Hp among all age groups gradually decreases, and the positive detection rate of Hp among patients aged 18~29 years old was the highest (73.25%); over 70 years old the positive detection rate of Hp in patients was the lowest (44.70%); the positive detection rate of Hp in elderly women over 70 was higher than that of men in the same age group, and the difference was statistically significant (P < 0.01). 2) The detection rate of chronic superficial gastritis (34.4%) and duodenal ulcer (19.1%) in the 18~29-year-old age group was higher than that of patients in other age groups; The detection rate of gastric polyps (7.30%) in the 60~69 years old age group is higher than that of other age groups. The detection rate of chronic atrophic gastritis (49.20%), reflux esophagitis (12.1%), and gastric cancer (8.30%) in patients over 70 years old was higher than that of other age groups (P < 0.05); there was no significant difference in gastric ulcer, bile reflux gastritis, erosive gastritis, duodenitis and other gastric-related lesions among all age groups (P > 0.05). 3) In gastric diseases, the positive detection rate of Hp in patients with duodenal ulcer was the highest (77.78%), and the positive detection rate of Hp in patients with gastric cancer was the lowest (39.58%), with significant statistical difference (P < 0.01). Conclusions: 1) Among adult patients with digestive system symptoms in Qinghai, the positive detection rate of Hp is different in different age groups, and the positive detection rate of Hp is gradually decreasing with age. 2) The gastric lesions of middle-aged and young patients are mainly chronic superficial gastritis and duodenal ulcer; the gastric lesions of middle-aged and elderly patients are mainly chronic atrophic gastritis, reflux esophagitis, gastric polyps and gastric cancer. 3) The positive detection rate of Hp is different in different types of gastric diseases. Among them, the detection rate of Hp is the highest in patients with duodenal ulcer and the lowest in patients with gastric cancer.