Smoak B L, Kelley P W, Taylor D N
Department of Advanced Preventive Medicine Studies, Walter Reed Army Institute of Research, Washington, DC 20307-5100.
Am J Epidemiol. 1994 Mar 1;139(5):513-9. doi: 10.1093/oxfordjournals.aje.a117034.
To study the prevalence and risk factors of Helicobacter pylori infection in healthy young adults, sera were collected from a nationwide sample of 404 females and 534 males (mean age, 20.2; range, 17-26 years) at induction into the US Army at Fort Jackson, South Carolina, during the fall of 1990. An enzyme-linked immunosorbent assay (PYLORI STAT, BioWhittaker, Inc., Walkersville, MD) was used to detect H. pylori-specific immunoglobulin G antibodies. Demographic data were obtained from a personnel database and by linking US census information to the subject's home address. The observed crude seropositivity rate was 26.3% (95% confidence interval 23.2-28.9). The direct sex-, race-, and geographic region-adjusted seropositivity rate was 20.8% (95% confidence interval 17.9-23.7). Seropositivity rates for blacks, Hispanics, and whites were 44%, 38%, and 14%, respectively, (chi 2, p < 0.001), and rates increased progressively from 24% in the age group 17-18 years to 43% in the age group 24-26 years (chi 2 for trend, p < 0.001). The age trends remained strong after controlling for race Median income was also an important predictive variable for seropositivity (chi 2, p < 0.0001). Sex, the percent urbanization, and population density of the home county were not significant predictors of seropositivity when age and race-ethnic group were controlled in a statistical model. The sharp increase in seroprevalence in this narrow age range suggests that the incidence rates are higher in young adults than previously reported.
为研究健康年轻成年人幽门螺杆菌感染的患病率及危险因素，于1990年秋季在南卡罗来纳州杰克逊堡对404名女性和534名男性（平均年龄20.2岁；范围17 - 26岁）进行入伍体检时采集血清样本。采用酶联免疫吸附测定法（PYLORI STAT，BioWhittaker公司，马里兰州沃克维尔）检测幽门螺杆菌特异性免疫球蛋白G抗体。人口统计学数据来自人事数据库，并通过将美国人口普查信息与受试者家庭住址相关联获取。观察到的粗血清阳性率为26.3%（95%置信区间23.2 - 28.9）。经性别、种族和地理区域直接调整后的血清阳性率为20.8%（95%置信区间17.9 - 23.7）。黑人、西班牙裔和白人的血清阳性率分别为44%、38%和14%（χ²检验，p < 0.001），且血清阳性率从17 - 18岁年龄组的24%逐渐上升至24 - 26岁年龄组的43%（趋势χ²检验，p < 0.001）。在控制种族后，年龄趋势依然明显。中位数收入也是血清阳性的重要预测变量（χ²检验，p < 0.0001）。在统计模型中控制年龄和种族 - 族裔组后，性别、家乡县的城市化百分比和人口密度不是血清阳性的显著预测因素。在这一狭窄年龄范围内血清阳性率的急剧上升表明，年轻成年人中的发病率高于先前报道。
