胃癌高发区居民胃癌前疾病的影响因素分析

目的探讨影响陕西省安塞县居民胃癌前疾病的相关因素,为胃癌的一级预防提供依据。方法 2010年5月至6月间通过胃镜联合胃黏膜活检的方法筛查出胃癌前疾病患者415例,在同一地区随机选择802名非消化系统疾病患者和健康人群作对照。取得知情同意后,对所有研究对象展开统一的问卷调查。采用成组比较的病例对照研究,建立多因素Logistic回归模型,计算各影响因素的OR值和95%CI。结果年龄大于40岁(OR=4.617,95%CI:1.516～14.061)、进餐时间不规律(OR=7.133,95%CI:1.290～39.446)、进食腌制食物(OR=25.540,95%CI:1.439～453.217)、常有紧张感或易激动(OR=3.753,95%CI:1.464～9.621)、睡眠质量差(OR=18.402,95%CI:2.444～138.569)和Hp感染(OR=12.145,95%CI:1.904～77.464)等因素会增加胃癌前疾病的患病风险,而经常进食新鲜果蔬(OR=0.012,95%CI:0.000～0.435)、有便后洗手的卫生习惯(OR=0.049,95%CI:0.011～0.221)则能降低患病风险。结论饮食因素、生活习惯、精神心理状况及Hp感染可能是影响安塞县居民胃癌前疾病发病的重要因素。对上述因素进行适当干预,有助于降低胃癌前疾病的发病率。

Factors for Gastric Precancerous Diseases:A Case-Control Study from One Area with High Incidence of Gastric Cancer

Objective To explore the factors influencing gastric precancerous diseases among the local residents at Ansai County,Shanxi Province,and provide evidence for primary prevention programs in the future.Methods During May to June 2010,415 patients with gastric precancerous diseases were dignosed by gastroscopy combined with biopsies.Then 802 subjects who were healthy or suffered from non-digestive diseases were selected randomly as the control group.All the subjects were interviewed with the unified questionnaires,and the entire course progressed on the premise of informed consent.In this case-control study,a multivariate analysis with non-conditional Logistic regression was carried out to evaluate the effects of the influencing factors on the basis of odds ratios(OR)and 95% confidence interval(95% CI).Results Age>40 years(OR=4.617,95% CI:1.516-14.061),irregular mealtime(OR=7.133,95% CI:1.290-39.446),pickled foods(OR=25.540,95% CI:1.439-453.217),frequent tension or agitation(OR=3.753,95% CI:1.464-9.621),poor quality of sleeping(OR=18.402,95% CI:2.444-138.569)and infection of H.pylori(OR=12.145,95% CI:1.904-77.464)could increase the risk of gastric precancerous diseases.However,eating fresh fruit and vegetables frequently(OR=0.012,95% CI:0.000-0.435),and the habit of washing hands after defecation(OR=0.049,95% CI:0.011-0.221)could reduce the risk.Conclusion In Ansai county,diet pattern,living habits,psychological status and the infection of H.pylori may be influencing factors of gastric precancerous diseases.Therefore,available intervention in these factors may contribute to reduce the incidence of gastric precancerous diseases.