1990～2001年上海市区幽门螺杆菌血清流行病学比较

目的：比较1990－2001年上海市区幽门螺杆菌（H.pylori)血清流行病学的改变，探讨H.pylori感染的危险因素。方法：2001年6－10月，应用检测H.pylori血清IgG抗体的酶免疫试剂盒，以酶联免疫吸附测定（ELISA）法检测上海市区1557位居民的血清标本，结合问卷形式调查市民的就餐、居住等生活环境因素，985人完成问卷调查；比较1990年和2001年2次调查的结果。以队列研究和多变量逐步Logistic回归方法分析H.pylori感染的危险因素。结果：2001年市区总体H.pylori阳性率为58.3%，高于1990年的42.7%(P=0.001)，低于1990年郊区的61.0%(P=0.116)。1－9岁和10－19岁年龄组的感染率与11年前相比无显著改变（29.7%、39.6%比27.4%、42.7%,P=0.683和P=0.707)，仍低于11年前郊区的水平（56.4%和57.3%,P=0.001和P=0.031)。70岁以上年龄组的感染率与11年前相比亦无显著差异（P=0.113)。30－69岁年龄组的H.pylori感染率较11年前显著升高（P＜0.05),20-69岁年龄组的H.pylori感染率与1990年郊区水平相当（P=0.276-0.935)。危险因素分析和逐步Logistic回归结果显示，年龄、家庭成员数＞3、户外聚餐等是H.pylori感染的危险因素。结论：我国城市经济发展、人口流动等引发的市民生活方式和环境改变可能影响H.pylori的流行病学特征，对H.pylori的防治工作提出了新的挑战。

Comparison of Seroepidemiology of Helicobacter pylori in Shanghai Urban Area during 1990and 2001

Aims: To compare the seroepidemiological changes of Helicobacter pylori (H. pylori) in Shanghai urban area during 1990 and 2001 and to explore the risk factors of H. pylori infection. Methods: The serum H. pylori IgG antibody in 1 557 residents living in Shanghai urban area was tested by using enzyme-linked immunosobent assay (ELISA) from June to October 2001 in order to make a comparison of seroprevalence of H. pylori during 1990 and 2001, and a questionnaire form was used to investigate the food, housing conditions and living environment, 985 individuals had completed the questionnaire forms, and cluster analysis and multivariate logistic regression analysis were used for exploring risk factors. Results: In Shanghai urban area the overall prevalence rate of H. pylori was 58.3% in 2001, higher than that in 1990 (42.7%, P= 0.001), but lower than that in Shanghai rural area in 1990 (61.0%), however, the difference was not statistically significant (P= 0.116). The comparison of the prevalence rates in those aged 1-9 and 10-19 years in Shanghai urban area during 1990 and 2001 showed no significant changes (29.7%, 39.6% vs 27.4%, 42.7%, P= 0.683 and P= 0.707, respectively), but in Shanghai urban area the prevalence rates of H. pylori in 2001 were lower than those of similar age groups in Shanghai rural area in 1990 (56.4% and 57.3%, P= 0.001 and P= 0.031, respectively). In Shanghai urban area the prevalence rate of H. pylori in those aged over 70 years showed no significant difference statistically as compared with that in 1990 (P= 0.113); those who aged 30-69 years showed higher prevalence rate of H. pylori than 11 years ago (P<0.05) and those who aged 20-69 years showed similar prevalence rate as compared with those of same age groups in Shanghai rural area in 1990 (P=0.276-0.935). Multivariate logistic regression analysis indicated that age, more than three members in a family, and always having dinner at restaurants were risk factors of H. pylori infection. Conclusions: In China, the economic development and the migration of people in the cities, which cause the changes of lifestyle and environment, might influence the characteristics of the epidemiology of H. pylori, and a new challenge for prevention and treatment of H. pylori infection is proposed.