山东和北京地区幽门螺杆菌感染的流行病学研究

目的 探讨中国胃癌高发区山东牟平和低发区北京延庆儿童及成人幽门螺杆菌(H.pylori,Hp)感染现状及变化.方法 2006年5-7月检测两地区8～15岁儿童和40～79岁成人2065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.结果 牟平儿童和成人Hp阳性率分别为37.69%和50.95%,显著高于延庆儿童和成人的25.58%和41.35%(P<0.01).与1991年相比,2006年牟平儿童Hp阳性率下降显著(P<0.001),而延庆儿章下降无统计学意义(P>0.05).两地区成人HP阳性率均显著下降(P<0.01).我院病例Hp感染率下降显著(P<0.001).结论 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.近十多年来Hp感染率在中国人群中有下降趋势.

Epidemiology of Helicobacter pylori infection in Shandong and Beijing areas

Objectives To study the current prevalence and recent epidemiological changes of Helicobacter pylori (H. pylori) infection among children and adults residing in regions with high ( Muping, Shandong) and low (Yanqing, Beijing) incidence of gastric cancer in China. Methods A total of 2065 asymptomatic children aged 8-15 years and adults aged 40-79 years in the above two regions were examined from May to July 2006. The data obtained in early 1990s in the same two areas and those of 11 656 patients undergoing endoscopy in our hospital in 1991 and 2006 were also collected and studied. Results The prevalence ofH. pylori infection in Muping was significantly higher than that in Yanqing among both children (37.69% vs25.58%, P<0.001) and adults (50.95% vs41.35%, P < 0. 01 ). From 1991 to 2006 H. pylori prevalence among children aged 8-10 years decreased in Muping (60. 00% vs 32. 07% , P < 0.001), but not in Yanqing (24.06% vs 19.10%, P > 0. 05 ) . A significant decrease in H. pylori prevalence among adults in both regions was observed when the results of 2006 were compared with the data obtained in 1990 in Muping (50.95% vs 73.78% , P < 0. 001 ) and in 1992 inYanqing (41.35% vs 55. 35% , P < 0. 01 ) . The detected rate of H. pylori infection in patients undergoing endoscopy in our hospital decreased from 51. 88% in 1991 to 33. 59% in 2006 (P <0. 001). Conclusions The prevalence of H. pylori infection is significantly higher in areas with a high incidence of gastric cancer in China as compared with that in areas with a low incidence of gastric cancer among both children and adults. H. pylori infection may be a risk factor in gastric carcinogenesis. In the past decade or more, H.pylori infection rates have decreased in Chinese population.