儿童及成人幽门螺杆菌感染患病率最近变化-在中国胃癌高或低发生率地区.pptVIP

研究背景 幽门螺杆菌(Helicobacter pylori，Hp)感染是全球性问题，据估计大约全世界50％以上人口的胃黏膜定植有Hp。相继有报道Hp感染率在不同国家，尤其是发达国家近年来有下降趋势。我国属于Hp感染率和胃癌发病率较高的国家，其感染现状及近15年来的变化少有报道。 研究目的 探讨我国胃癌高发区山东牟平和低发区北京延庆儿童及成人Hp感染现状及自20世纪90年代初至2006年的变化。并研究Hp感染与胃癌及肠化类型的关系。 研究方法 北医三院消化科周丽雅教授等选取2006年5-7月检测两地区（北京延庆和山东牟平）8～15岁儿童和40～79岁成人2 065例。收集同地区90年代初资料及1991年和2006年于我院进行胃镜检查的所有病例11 656例，分析Hp感染率变化。 研究结果 牟平儿童和成人Hp阳性率均显著高于延庆； 与1991年相比，2006年牟平儿童Hp阳性率下降显著，而延庆儿章下降无统计学意义； 两地区成人Hp阳性率均显著下降； 我院病例Hp感染率下降显著。 结论 该研究初步证实了： 近十多年来Hp感染率在中国人群中有下降趋势； 胃癌高发区儿童和成人Hp感染率显著高于胃癌低发区，Hp感染可能是胃癌发生的危险因素之一。 Background The prevalence of Helicobacter pylori (H. pylori) infection varies by geographic locations. Studies indicate that the infection rate of H. pylori was previously high in China but that rates had been declining worldwide over recent decades. The aims of our study were: (1) to determine the current prevalence of H. pylori infection among children and adults residing in areas with high (Muping County, Shandong) and low (Yanqing County, Beijing) incidences of gastric cancer in China, and (2) to compare the prevalence for 2006 with the prevalence for the early 1990s. Methods Using Warthin-Starry silver staining of gastric mucosal biopsy specimens and H. pylori stool antigen tests (HpSA), we tested a total of 2065 asymptomatic children aged 8–15 years and adults aged 40–79 years in the above two regions from May to July 2006. We evaluated 520 children and 526 adults from Muping, and 516 children and 503 adults from Yanqing. Subjects were selected randomly and H. pylori status was determined by HpSA in children and either HpSA or histology of gastric biopsies in adults. Data obtained in the early 1990s in the same two areas of China were also collected and studied. Results For children, the prevalence of H. pylori infection was significantly higher in Muping (37.69%) than it was in Yanqing (25.58%, P 0.001). In both regions, the prevalence of H. pylori increased with age but was not related to gender. A significant difference was observed betwe