日本农村人口幽门螺杆菌感染的危险因素：与生活环境和病史的关系。

Risk factors for Helicobacter pylori infection among a rural population in Japan: relation to living environment and medical history.

作者信息

Nishise Yuko, Fukao Akira, Takahashi Tatsuya

机构信息

Division of Public Health and Preventive Medicine, Department of Diagnostic Information and Socioenvironmental Medicine, Yamagata University School of Medicine, Iida-nishi, Japan.

出版信息

J Epidemiol. 2003 Sep;13(5):266-73. doi: 10.2188/jea.13.266.

DOI:10.2188/jea.13.266

PMID:14604222

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9691395/

Abstract

BACKGROUND

Helicobacter pylori infection is related to several gastroduodenal diseases, though the route of transmission remains unclear.

METHODS

A cross-sectional study that included 695 healthy people (males 308, females 387; median age 60 years) participating in a health checkup program in Yamagata Prefecture was conducted. H. pylori status was determined in all subjects by evaluation of serum anti-H. pylori immunoglobulin G antibody. Antibody against hepatitis A virus was used as a marker of fecal-oral exposure to assess the agreement between H. pylori infection and hepatitis A virus infection. Data on other factors known or suspected to be related to infection status were also collected using a questionnaire.

RESULTS

Seroprevalence of H. pylori and hepatitis A virus was 60% and 70%, respectively. Kappa values for subjects aged 20-49 and aged 50 or older were 0.07 and 0.02, respectively, and agreement between the presences of both infections was assessed as slight. In the multivariate logistic regression analysis, H. pylori infection was significantly associated with availability of a sewage system in childhood (presence [reference], absence [odds ratio (OR) = 4.06, 95% confidence interval (CI): 1.36-13.94]) and the number of gastrointestinal endoscopies undergone (none [reference], once [OR = 1.64, 95% CI: 0.83-3.27], 2-3 times [OR = 3.11, 95% CI: 1.65-5.99], or 4 or more times [OR = 3.18, 95% CI: 1.71-6.03]), (p < 0.01 for trend).

CONCLUSIONS

Our results suggest that poor hygiene in childhood is related to H. pylori infection. The fecal-oral route does not seem to be an important mode of transmission, but the possibility of transmission by gastrointestinal endoscopic examination exists.

摘要

背景

幽门螺杆菌感染与多种胃十二指肠疾病相关，但其传播途径仍不清楚。

方法

进行了一项横断面研究，纳入了695名参与山形县健康体检项目的健康人（男性308名，女性387名；中位年龄60岁）。通过评估血清抗幽门螺杆菌免疫球蛋白G抗体来确定所有受试者的幽门螺杆菌感染状况。将甲型肝炎病毒抗体用作粪口暴露的标志物，以评估幽门螺杆菌感染与甲型肝炎病毒感染之间的一致性。还通过问卷调查收集了其他已知或疑似与感染状况相关因素的数据。

结果

幽门螺杆菌和甲型肝炎病毒的血清阳性率分别为60%和70%。20 - 49岁和50岁及以上受试者的kappa值分别为0.07和0.02，两种感染并存的一致性被评估为轻微。在多因素逻辑回归分析中，幽门螺杆菌感染与儿童时期是否有污水处理系统（有[参照]，无[比值比(OR)=4.0, 95%置信区间(CI): 1.36 - 13.94]）以及接受胃肠内镜检查的次数（无[参照]，1次[OR = 1.64, 95% CI: 0.83 - 3.27]，2 - 3次[OR = 3.11, 95% CI: 1.65 - 5.99]，或4次及以上[OR = 3.18, 95% CI: 1.71 - 6.03]）显著相关（趋势p < 0.01）。