海南汉区就诊患者幽门螺杆菌感染现状分析

目的调查海南汉区在消化内科就诊患者中幽门螺杆菌（Helicobacter pylori，H．pylori）感染患病情况，以及幽门螺杆菌感染与胃黏膜病理的关系。方法选择海南汉区10个县市2395例具有上消化道症状就诊患者，经胃镜检查并取胃窦黏膜做H．pylori快速尿素酶试验，阳性患者做^14C呼气试验，两者阳性确定为幽门螺杆菌感染。1004例幽门螺杆菌阳性患者取胃窦及病变部位胃黏膜做病理组织检查。选取113例排除消化道疾病的健康体检人员作为对照组。结果就诊患者中和对照组中幽门螺杆菌感染率分别为48．73％，10．46％；患有上消化道疾病患者的H．pylori感染显著高于正常体检者（P〈0．01）。但与10年前全国H．pylori平均感染率58．07％相比，本地区H．pylori感染现状已下降17．18％（SMR=0．839）。1004例患者胃窦黏膜和病变部位活检结果显示不同胃黏膜病理改变H．pylori感染率不同（P〈0．01），异型增生或肠上皮化生者H．pylori感染率明显高于其他组（P〈0．01）。结论施行根除幽门螺杆菌治疗后10年海南地区H．pylori感染已经有好转，但是仍然为高感染区。根除H．pylori治疗仍然是今后治疗H．pylori相关性疚病的主要策略。怠有慢性浅表性胃炎、慢性萎缩性胃炎、胃癌、消化性溃疡、胃息肉的患者H．pylori阳性率相似。H．pylori感染与胃黏膜的萎缩、肠化生和异型增生等癌前期病变的关系更为密切。

Analysis of prevalent status of Helicobacter pylori infection in outpatients of gastrointestinal department in Han Nationality inhabitants of Hainan

Objective To survey the prevalence of Helicobacter pylori （ H. pylori ） in gastrointestinal out - patient department in Han group in Hainan. Methods There 2 395 patients from ten counties or cities in Han group in Hainan at gastrointestinal out - patient department of the hospital were detected by rapid urease test of H. pylori and gastroscope. The posititives of rapid urease test of H. pylori were determined with ^14C - urea breath test （^14C - UBT）. Two positive tests were confirmed to be infected with H. pylori. Biopsy was performed on 1 004 patients positive for H. pylori. 113 healthy people were enrolled in control group, Results The rate of H. pylori infection in outpatients and control group were 48.73%, 10.46%, respectively. The rate of H. pylori infection in patients with upper gastrointestinal diseases was higher than control group （P 〈 0.01 ）. But now the rate of H. pylori infection in Hainan was significantly reduced by 17.18% （SMR= 0.839） than that in all over the country 10 years ago （58.07%）. The results of biopsy of 1 004 patients showed that different pathological changes in gastric mucosa were different in H. pylori infection （P 〈 0.01 ）, and the rate of H, pylori infection in the patients with dysplasia or intestinal metaplasia was higher than that in other patients （ P 〈 0.01 ）, Conclusion The rate of H, pylori infection has been reduced since adopted eradication therapy H. pylori in last 10 years in Hainan. The H. pylori eradication therapy is still the main strategy for curing gastrointestinal diseases associated with H. pylori in future, H. pylori infection is closely associated with precancerous proess such as atrophy and intestinal metaplasia and dysplasia.