Epidemiological survey of Helicobacter pylori infection in Tibetan population in Gangcha of Qinghai, 2017–2018
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摘要:
目的分析青海省刚察地区藏族人群幽门螺杆菌（HP）感染的现状及相关因素，为我国高原地区藏族HP感染防治提供依据。 方法2017年8月至2018年11月按全国HP科研协作组制定的流行病学调查方法，在刚察县随机抽样2 103名藏族人群进行调查，采用14C尿素呼气试验检测其HP感染情况。 结果2 103名藏族人群中，HP感染率为74.13%，男、女性HP感染率分别为75.76%和72.59%，差异无统计学意义（χ2＝2.744，P＝0.054）。 20～39岁年龄组为HP感染率高峰段，为78.32%。 距离县城近、卫生和交通条件好的乡镇调查人群感染率低。 距离县城较远的偏远地区、文化程度低、家庭收入低和职业为牧民者HP感染率高。 文化程度越高，HP感染率越低（χ2＝364.351，P＜0.05）；牧民HP感染率最高76.25%（1 191/1 562）；家庭收入越低，HP感染率越高（χ2＝6.659，P＜0.05）。 HP感染家庭集聚感染率也很高。 结论2017－2018年刚察地区藏族人群幽门螺杆菌感染率高于全国人群自然感染率，牧民是HP感染的高危人群，良好的卫生饮食习惯和社会经济状况可能影响HP感染率。 Abstract:ObjectiveTo analyze the current status of Helicobacter pylori infection and related factors in Tibetan population in Gangcha county, a high altitude area on the north bank of Qinghai Lake, in Qinghai and provide evidence for the prevention and treatment of H. pylori infection in Tibetan population in plateau areas of China. MethodsFrom August 2017 to November 2018, a total of 2 103 Tibetans were randomly sampled in Gangcha for an epidemiological survey according to the protocol developed by the National Helicobacter pylori Research Cooperative Group. The H. pylori infection was detected by using 14C urea breath test. ResultsAmong 2 103 Tibetans, the HP infection rate was 74.13%, and the infection rates of H. pylori in men and women were 75.76% and 72.59%, respectively, The difference was not significant (χ2＝2.744, P＝0.054). The infection rate of H. pylori was highest in age group 20–39 years (78.32%). The infection rate was low in the townships which were close to the county town and have good sanitation and transportation conditions. In the remote areas far from the county town, the infection rate of H. pylori was high in herdsmen and those with low family income and low education level. The higher the education level was, the lower the infection rate of H. pylori was (χ2＝364.351, P＜0.05). Herdsmen had the highest infection rate of H. pylori (76.25% (1 191/1 562). The lower the family income was, the higher the infection rate of H. pylori was (χ2＝6.659, P＜0.05). The H. pylori also had a high infection rate in families. ConclusionThe infection rate of H. pylori in Tibetans in Gangcha was higher than the national natural infection rate during 2017–2018. Herdsmen were at high risk for H. pylori infection. Good dietary habits and socio-economic conditions might reduce the infection rate of H. pylori. -
Key words:
- Plateau /
- Gangcha area /
- Tibetan /
- Helicobacter pylori /
- Epidemiological survey
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表 1 2017－2018年刚察县各乡镇不同性别藏族人群幽门螺杆菌感染情况
Table 1. Gender specific infection status of Helicobacter pylori in Tibetans in townships of Gangcha，2017–2018
乡镇 人数 幽门螺杆菌感染检查结果 χ2值 P值 阳性数（例） 阳性率（%） 阴性数（人） 阴性率（%） 吉尔孟乡 400 324 81.00 76 19.00 3.539 0.040 男性 202 171 84.65 31 15.35 女性 198 153 77.27 45 22.73 泉吉乡 400 312 78.00 88 22.00 6.885 0.006 男性 181 152 84.00 29 16.00 女性 219 160 73.10 59 26.90 伊克乌兰乡 403 303 75.20 100 24.80 1.842 0.107 男性 197 154 78.20 43 21.80 女性 206 149 72.30 57 27.70 哈尔盖镇 400 281 70.25 119 20.75 0.338 0.318 男性 178 121 67.97 55 30.90 女性 222 160 72.07 64 28.83 沙柳河镇 500 339 67.80 161 32.20 0.597 0.250 男性 267 177 66.29 90 33.70 女性 233 162 69.53 71 30.50 
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表 2 幽门螺杆菌感染与调查人群一般情况之间的关系
Table 2. Relationship between Helicobacter pylori infection and the general situation of the investigated population
项目 人数 幽门螺杆菌感染检测结果 χ2值 P值 阳性数（例） 阳性率（%） 阴性数（人） 阴性率（%） 性别 2 103 1 559 74.13 544 25.87 2.744 0.054 男性 1 023 775 75.76 248 24.24 女性 1 080 784 72.59 296 27.41 年龄组（岁） 24.981 ＜0.001 0 ~ 489 383 78.32 106 21.68 30 ~ 574 436 75.96 138 24.04 40 ~ 539 396 73.47 143 26.53 50 ~ 304 223 73.36 81 26.64 60 ~ 197 119 60.41 78 39.59 职业 136.319 ＜0.001 牧民 1 562 1 191 76.25 371 23.75 公职人员 519 356 68.59 163 31.41 学生a 17 14 82.35 3 17.65 文化程度 364.351 ＜0.001 初中及以下 1 392 1 054 75.72 338 24.28 高中及中专 64 57 89.06 7 10.93 大专以上 487 237 48.67 250 51.33 婚姻状况 1.965 0.580 未婚 125 93 74.40 32 25.60 已婚 1 904 1 415 74.32 489 25.68 离异 15 12 80.00 3 20.00 丧偶 57 38 66.67 19 33.33 常住地 15.558 ＜0.001 县城 521 354 67.95 167 32.05 乡镇 50 40 80.00 10 20.00 牧区 1 532 1 171 76.44 361 23.56 家庭共同生活人数 10.452 0.005 2 ~ 3 695 485 69.78 210 30.22 4 ~ 5 1 234 944 76.50 290 23.50 ＞5 174 128 73.56 46 26.44 家庭人均月收入（元） 6.659 0.036 ＜1 000 152 120 78.95 32 21.05 1 000 ~ 1 360 991 72.87 319 23.46 ≥3 000 641 455 70.98 186 29.02 注：a. 采样数据较少本次暂不做统计学分析
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表 3 幽门螺杆菌感染与个人生活方式、饮食习惯和日常生活情况之间的关系
Table 3. Relationship between Helicobacter pylori infection and personal lifestyle，dietary habits and daily life
个人生活
习惯人数 幽门螺杆菌感染检测结果 χ2值 P值 阳性数（例） 阳性率（%） 阴性数（人） 阴性率（%） 吸烟 5.756 0.009 是 449 353 78.62 96 21.38 否 1 654 1 208 73.04 446 26.96 饮酒 0.002 0.507 是 536 398 74.25 138 25.78 否 1 567 1 162 74.15 405 25.85 饮茶 1.219 0.170 是 1 979 1 603 81.00 376 19.00 否 70 53 76.00 17 24.00 饭前便后洗手 2.208 0.076 是 1 415 1 039 73.43 376 26.57 否 688 524 76.16 164 23.84 共用餐具 2.711 0.055 是 553 424 76.67 129 23.33 否 1 550 1 133 73.10 417 26.90 共用水杯 2103 ＜0.001 是 587 448 76.32 139 23.68 否 1 516 1 124 74.14 392 25.86 碗筷清洗 1.962 0.115 是 2 067 1 534 74.21 533 25.79 否 36 23 63.89 13 36.11 饮用水源 0.022 0.989 自来水 1 589 1 174 73.88 415 26.12 井水 447 331 74.05 116 25.95 其他 67 50 74.63 17 25.37
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表 4 消化道症状与幽门螺杆菌感染的关系
Table 4. Relationship between gastrointestinal symptoms and Helicobacter pylori infection
健康状况 人数 幽门螺杆菌感染检测结果 χ2值 P值 阳性数
（例）阳性率（%） 阴性数
（人）阴性率（%） 近3个月反酸、烧心、胃痛、口臭、食欲
不振10.956 ＜0.001 是 469 377 80.38 92 19.62 否 1 634 1 190 72.83 444 27.17 慢性胃炎史 4.409 0.020 是 443 346 78.10 97 21.90 否 1 660 1 215 73.19 445 26.81 消化性溃疡史 19.908 ＜0.001 是 300 212 70.67 88 29.33 否 1 803 1 339 74.27 464 25.73 慢性胆囊炎胆结石史 0.523 0.258 是 242 175 72.31 67 27.69 否 1 861 1 386 74.48 475 25.52 胃肠道家族史 0.003 0.513 是 142 105 73.94 37 26.06 否 1 961 1 454 74.15 507 25.85 配偶胃病史 0.804 0.210 是 186 143 76.88 43 23.12 否 1 917 1 416 73.87 501 26.13
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