河北省某农村人群乙型和丙型肝炎病毒感染的调查

报告河北省某农村人群ＨＢＶ与ＨＣＶ感染的调查结果。该人群ＨＢＶ总感染率为５５．２％，以１０￣１９岁组最高，为６７．１％；抗－ＨＣＶ阳性率为７．１％，以４０￣４９岁组最高，为２１．１％，１０岁以下和６０岁以上组无１例抗－ＨＣＶ阳性。ＨＢＶ感染具有明显家庭聚集性，ＨＣＶ感染无家庭聚集性。父母ＨＢｓＡｇ均阳性的子女，其ＨＢｓＡｇ阳性率（３２．６％）明显高于父母均阴性者（１５．６％），但父母抗－ＨＣＶ阳性     

输血后丙型肝炎和献血员抗—HCV的动态观察

对输血后丙型肝炎（丙肝）和献血员抗－ＨＣＶ进行随访。结果：１９９１年７月至１９９３年６月输血后丙肝的发病率为４６．６６％，明显高于１９８９年５月至１９９０年１１月输血后丙肝的发病率（５．８１％）。献血员抗－ＨＣＶ阳性率分别为：１９８７年１．１６％、１９９０年６．９７％、１９９２￣１９９３年３６．８０％，这一特点与输血后丙肝发病趋势一致，亦与本地单采血浆量增加有关。     

输血后丙型肝炎和献血员抗－HCV的动态观察

对输血后丙型肝炎（丙肝）和献血员抗－ＨＣＶ进行随访。结果：１９９１年７月至１９９３年６月输血后丙肝的发病率为４６．６６％，明显高于１９８９年５月至１９９０年１１月输血后丙肝的发病率（５．８１％）。献血员抗－ＨＣＶ阳性率分别为：１９８７年１．１６％、１９９０年６．９７％、１９９２～１９９３年３６．８０％，这一特点与输血后丙肝发病趋势一致，亦与本地单采血浆量增加有关。     

500例多聚人血清白蛋白受体检测结果分析

用反向间接血凝法（ＲＰＨＡ）检测ＨＢｓＡｇ和多聚人血清白蛋白受体（ＰＨＳＡ－Ｒ），用酶联免疫吸附试验（ＥＬＩＳＡ）检测ｅ系统，在受检的５００例血清中，检测ＨＢｓＡｇ阳性者３３５例，其中ＰＨＳＡ－Ｒ阳性率为２３．６％，年龄分布：１￣２０岁阳性率为４６．７％，２１￣４０岁２２．２％，４１￣６０岁２２．６％，６０岁以上５．３％，以小年龄组阳性率为最高，１１９例ＨＢｓＡｇ阴性者中无一例ＰＨＳＡ－Ｒ阳性。     

韶关市麻疹减毒活疫苗初始强化免疫的效果分析

为探讨初始强化免疫对控制和消除麻疹的效果,１９９８ 年６ ～７ 月份对韶关市所有６ 月龄至１５ 岁人群实施ＭＶ 初始强化免疫后进行血清学检测和流行病学观察。结果强免后麻疹总抗体阳性率从９０－８ ％ 升至９９－５ ％ ,ＧＭＲＴ 从８６１－８ 增长到４６６０－２ ,低抗体率从３１－０ 降至１－８ ％ ,免疫成功率高达９８－９ ％ ;强免后（１９９８ 年７ ～１２ 月、１９９９ 年１ ～５ 月） 麻疹发病报告分别为２７ 例和１ 例,比强免前（１９９８ 年１ ～６ 月２５２ 例） 大幅度下降。说明ＭＶ 初始强化免疫控制麻疹效果显著,是控制和消除麻疹的可取策略。     

河南省健康人群及急性散发性肝炎中抗—HEV水平调查

对河南省不同地区５８９８名健康人群及５９２名急性散发性肝炎病例的戊肝检测。结果显示：健康人群中，抗－ＨＥＶ阳性率为８．６％，男性为７．６％，女性为９．５％，女性感染率高于男性，抗－ＨＥＶ阳性率随年龄的增大而增高，地区间存在有明显差异。急性散发性肝炎中戊肝占９．５％，发病年龄在５￣１０岁和２５￣４０岁组间比较集中，占总病例的６６．１％，平均发病年龄为２２．９岁，男性发病多于女性，但无显著性差异。结果     

乙肝疫苗免疫持久性效果观察

以广州铁路局某幼儿园１３０名２～５岁正常幼儿为对象，按０、１、６月接种方案进行乙肝疫苗（总量３０μｇ）接种，免后７个月、１、２、５年以ＲＩＡ法检测抗－ＨＢｓ。结果免后１年达抗体峰值期．ＧＭＴ达１∶１５０．８０，Ｓ／Ｎ≥１０者达１００％，高、中、低抗体反应者分别占９０．８２％～５．５％和３．６８％，免后５年抗－ＨＢｓ阳性率仍维持在７４．６５％，ＧＭＴ为１∶１９．９３。建议可暂不考虑免后５年的加强免疫。     

河南省健康人群及急性散发性肝炎中抗－HEV水平调查

对河南省不同地区５８９８名健康人群及５９２名急性散发性肝炎病例的戊肝检测。结果显示：健康人群中，抗－ＨＥＶ阳性率为８．６％，男性为７．６％，女性为９．５％，女性感染率高于男性，抗－ＨＥＶ阳性率随年龄的增大而增高，地区间存在有明显差异。急性散发性肝炎中戊肝占９．５％，发病年龄在５～１０岁和２５～４０岁组间比较集中，占总病例的６６．１％，平均发病年龄为２２．９岁，男性发病多于女性，但无显著性差异。结果提示，河南省存在有戊肝流行，并为今后的流行病学研究提供了依据。     

肝炎患者柯萨奇B组病毒感染状况及其关系的探讨

用免疫酶组化法对１２１例各型临床肝炎患者和１０８名献血员进行了抗－ＣＶＢＩｇＭ和ＩｇＧ检测。两组的阳性率分别为９．９％、１９．８％和８．３％、３６．１％，总阳性率分别是２５．６％和４０．７％；非乙型肝炎患者抗－ＣＶＢＩｇＭ和ＩｇＧ及总阳性率为１３．８％、２４．１％和３１．０％，乙肝患者抗－ＣＶＢＩｇＭ、ＩｇＧ及总阳性率分别为６．３％、１５．９％和２０．６％。肝炎患者，尤其是乙肝患者抗－ＣＶＢＩｇＧ及总阳性率与对照组差异有显著性。结果提示：乙肝患者可能对ＣＶＢ感染的免疫应答较低，因此其抗－ＣＶＢ检出率低；也可能是因为ＨＢＶ感染后，对再感染ＣＶＢ有干扰作用之故。其详细机理有待进一步研究     

河南省戊肝病毒感染的血清流行病学调查研究

１９９２－１９９４年，在河南省十三个市县，进行了戊肝病毒的流行病学调查，受检人数５８９８，结果显示：我省十三个市县均有戊型肝炎存在，抗－ＨＥＶ阳性率为８．６％，各地感染率存在显著性差异。城乡抗－ＨＥＶ阳性率分别为９．０％和８．。４％。男女抗－ＨＥＶ阳性率分别为７．６％和９．５％，女性明显高于男性。     

Diabetes mellitus and Helicobacter pylori infection

Alterations of glucose metabolism in diabetes have been suggested as promoting Helicobacter pylori colonization. We performed a cross-sectional sero-prevalence study of diabetic patients (insulin-dependent, or type 1, and non-insulin-dependent, or type 2, diabetes mellitus) with H. pylori and compared them with a control group. Consecutive diabetic outpatients aged 12 to 75 y and with disease duration of greater than 1 y were enrolled. Helicobacter pylori status was evaluated by using an enzyme-linked immunosorbent assay for anti-H. pylori immunoglobulin G. Demographic data were obtained from each individual, and socioeconomic class was assessed by occupation and education level. A total of 891 individuals participated (240 with type-2 diabetes, 145 with type-1 diabetes, and 506 control subjects). After controlling for age, there was no significant difference in the prevalence of H. pylori infection in any age group. In fact, the prevalence of H. pylori was numerically higher among children in the control group than among children with type-1 diabetes (25% versus 9%, respectively; P = 0.1). Previous associations of H. pylori and diabetes may have arisen from failure to consider socioeconomic status or age. Because childhood is the most common period for acquisition of H. pylori infection, the higher prevalence of infection among the normal children as opposed to those with type-1 diabetes confirms the lack of an association.     

北京地区老年人群幽门螺杆菌感染的血清流行病学研究

目的评价北京地区老年人群幽门螺杆菌（Hp）及其亚型（CagA，VacA）感染的血清流行率及影响因素。方法采用整群随机抽样的方法入户问卷调查了北京不同地区（城区、郊区、山区）60岁及以上的老年人2006名，应用免疫印迹法测定血清Hp CagA、VacA和Ureas抗体。结果老年人群总的Hp感染率为83．4％，Ⅰ型Hp菌株感染率为56．0％；郊区和城区高于山区（P〈0．001）；以体力劳动为主的老年人Hp菌株的感染率高于以脑力劳动为主的老年人（P〈0．05）；以素食为主的老年人Ⅰ型Hp菌株感染率显著高于以高蛋白饮食为主的老年人（P〈0．001）。结论Hp在北京地区老年人群中存在着较高的血清流行率，以Ⅰ型Hp菌株感染为主，其亚型分布在年龄、地区和饮食习惯上存在显著差异。     

十二指肠球部溃疡血清胃泌素与幽门螺杆菌相关性研究

对３１ 例Ｄｕ 患者及３１ 例慢性胃炎患者进行ＨＰ 检测及血清胃泌素测定,并对其中２３ 例ＨＰ阳性Ｄｕ 患者抗ＨＰ 治疗后的血清胃泌素及ＨＰ 进行测定。结果显示ＨＰ 检出率Ｄｕ 组为７４ ．１９ ％ （２３／３１） ,较慢性胃炎组４８ ．３９ ％ （１５／３１） 高（ Ｐ＜ ０ ．０５） ;ＤｕＨＰ 阳性组的血清胃泌素较ＤｕＨＰ 阴性组、慢性胃炎ＨＰ 阳性组及慢性胃炎ＨＰ 阴性组明显增高（ Ｐ 均＜ ０ ．０５） ,而ＤｕＨＰ 阴性组的血清胃泌素与慢性胃炎ＨＰ 阳性组及慢性胃炎ＨＰ 阴性组比较差异无显著性（ Ｐ＞ ０ ．０５） ,２３ 例ＤｕＨＰ 阳性者抗ＨＰ 治疗后,ＨＰ转阴者的血清胃泌素较治疗前明显下降（Ｐ＜ ０ ．０５） ,ＨＰ 未转阴者的血清胃泌素前后差异无显著性（ Ｐ＞０．５） 。提示Ｄｕ 血清胃泌素与幽门螺杆菌感染有一定相关性。     

性别间和家庭聚集的幽门螺杆菌感染的Meta分析

目的：综合分析并探讨幽门螺杆菌感染情况，方法：运用Meta分析方法对幽门螺杆菌性别间和家庭聚集的研究进行综合定量分析，结果：性别间幽门螺杆菌感染率有细微差别（95％CI：0．0579－0．0963）；父母均阳性子女幽门螺杆菌感染率较父母均阴性者为高（95％CI：0．3378－0．5042）。结论：幽门螺杆菌感染率存在性别差异和家庭聚集现象，幽门螺杆菌流行病学研究涉及很多方面，但均缺乏足够调查和证据。尚需进一步研究。     

Helicobacter pylori infection in children: prevalence, diagnosis and treatment outcome

The clinical significance of Helicobacter pylori infection in children remains largely unknown. The rate of acquisition at different ages has not been ascertained using reliable tests on gastric biopsies. We determined prospectively the prevalence of H. pylori infection in children and its association with gastroduodenal disease. We evaluated 240 children undergoing upper gastrointestinal endoscopy for H. pylori infection by rapid urease test, culture, ureA PCR and histopathology. Group I constituted 58 children with upper abdominal pain (UAP) and group II (controls) of 182 children without UAP who underwent diagnostic or therapeutic endoscopy for other reasons. Helicobacter pylori-positive children with UAP received anti-H. pylori therapy. Helicobacter pylori infection was significantly higher in children with UAP than controls (53.4% vs. 28%; P<0.001) and overall prevalence increased with age. On follow-up endoscopy, H. pylori had been eradicated from 82% of children with UAP; it was eradicated from the remaining 18% after a second regimen. Treated H. pylori-positive children with UAP remained symptom-free for a median of 25 months. Control children remained chronically H. pylori infected. Chronic inflammation was present in all infected children, and active inflammation in 48.8%. The study shows H. pylori infection increases with age and is strongly linked to UAP in children.     

不同形式胃泌素在幽门螺杆菌致病中的作用

  目的  探讨幽门螺杆菌(Helicobacter pylori, H.pylori)感染对血清胃泌素及外泌体源性胃泌素的影响。  方法  随机收集79例慢性胃炎患者血清,13C呼气试验判断H.pylori感染情况,ELISA法测定血清胃泌素和外泌体源性胃泌素浓度。  结果  血清胃泌素及外泌体源性胃泌素在非萎缩性胃炎(non-atrophic gastritis, NAG)与萎缩性胃炎(atrophic gastritis, AG)两组患者中差异均无统计学意义(t=-0.197, P=0.844; t=0.221, P=0.826)。在NAG患者中,H.pylori阳性亚组血清胃泌素及外泌体源性胃泌素均低于H.pylori阴性亚组(t=2.488, P=0.017; t=2.655, P=0.012)。而在AG患者中,血清胃泌素浓度在H.pylori阳性与阴性两亚组中差异无统计学意义(t=1.888, P=0.082);但外泌体源性胃泌素在H.pylori阳性亚组高于H.pylori阴性亚组(t=2.394, P=0.029)。  结论  H.pylori感染早期、胃黏膜发生萎缩前,血清胃泌素下降;当H.pylori持续感染导致萎缩后,血清外泌体源性胃泌素分泌增加,胃泌素多以外泌体形式存在,并可能参与了H.pylori感染致病分子机制。     

Correspondence between Helicobacter pylori antibodies and urea breath test results in a US-Mexico birth cohort

The uncertain accuracy of methods for detecting Helicobacter pylori infection in young children complicates research on this infection in early life. The aim of the present report was to describe the correspondence between positive serology and positive urea breath test (UBT) in children followed from age 0 to 24 months in the Pasitos Cohort Study, conducted along the US-Mexico border at El Paso and Juarez. Children were recruited before birth during 1998-2000 and examined at target ages of 6, 12, 18 and 24 months. H. pylori infection was detected using an enzyme immunoassay for serum immunoglobulin G antibodies and the (13)C-urea breath test corrected for age-dependent variation in CO(2) production. Of 472 children, 125 had one or more positive UBT results and 46 had one or more positive serology results. The prevalence of H. pylori infection at target ages of 6, 12, 18 and 24 months was 7%, 14%, 16% and 19%, respectively, by UBT and 8%, 2%, 3% and 3%, respectively, by serology. Few (<1%) of those tested on both tests were positive on both at any age. Among UBT-positive children, 6% were concurrently seropositive and 6% became seropositive later. Because UBT positivity cut points were selected to minimise false positives, these results suggest that H. pylori infection occurred frequently in this cohort, but rarely produced detectable antibodies. For clinical or epidemiological investigations, serology should not be used as the sole method for detecting H. pylori infection in children aged 2 years or less.     

Determinants of geographic variation in Helicobacter pylori infection among children on the US-Mexico border

Rates of Helicobacter pylori infection are traditionally higher in developing countries than in developed countries, but the specific reasons for these differences are not fully clear. While chronic diseases resulting from H. pylori are generally of adult onset, chronic infection usually begins in childhood. In this cross-sectional study (1998-2000), the authors compared prevalences of H. pylori infection among children under age 6 years on both sides of the Rio Grande. Participants included 264 children of women from low-income families who were receiving services at health clinics in Juarez, Mexico, or El Paso, Texas, from April 1998 through October 2000. Data were collected through personal interviews and serologic testing for H. pylori antibodies. The crude odds ratio for H. pylori prevalence among Mexican children as compared with US children was 3.94 (95% confidence interval: 1.72, 9.06). After adjustment for covariates, the odds ratio decreased to 1.70 (95% confidence interval: 0.64, 4.52). The adjustments that produced the greatest reduction in the odds ratio for location were those for household crowding and maternal education. This study identified specific factors that may explain geographic variation in H. pylori prevalence among children.     

Prevalence and possible risk factors of Helicobacter pylori infection among children attending Damanhour Teaching Hospital

Helicobacter pylori (H. pylori) is a major cause of gastrointestinal disease in children. The factors influencing the acquisition and prevalence of H. pylori infection remain incompletely understood. In the present study, the prevalence and possible risk factors of H. pylori infection were studied among children aged 1.5-16 years who were attending the pediatric outpatient clinic of Damanhour Teaching Hospital. Blood samples were drawn and IgG seroprevalence of H. pylori among the studied children was determined using ELISA kits. A specially designed questionnaire inquired about personal, socioeconomic, household characteristics, feeding history during infancy and the child's health data was completed for every child. Results revealed that the overall seroprevalence of H. pylori infection was 50.5 %. The prevalence was widely age dependent: it was 60.6% among those age > or = 5 years and only 25.9% among those < 5 years (OR = 4.4; 95% CI = 1.6-11.9). Increased crowding in bed was also an associated factor; the prevalence among children where > or = 3 share a bed was 59.7% compared to only 26.9% among those where < 3 persons share a bed (OR = 4.1; 95% CI = 1.5-10.9). The prevalence among children who were breast fed for < 1 year was 64.7% compared to only 42.4% among those who were fed for > or =1 year (OR = 2.5; 95% CI = 1.1-5.9). After controlling for possible confounding in a Stepwise Multiple Logistic Regression model, independent predictors for H. pylori infection were: increasing age (> or = 5 years), overcrowding in bed (> or = 3/ bed) and shorter duration of breast-feeding (< 1 year) during infancy. It could be concluded that, H. pylori was highly prevalent among the sampled children and the possible risk factors are related to the community. So, there is a need to early diagnose, treat and eradicate infection during childhood to prevent its complications during adulthood.