消化内科住院患者幽门螺杆菌现症感染状况的调查研究

发布时间：2018-05-05 05:30

本文选题：消化内科 + 住院患者　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]自Marshall和Warren发现幽门螺杆菌(Helicoibacter pylori,HP)以来,人们对HP的研究愈来愈多,对其认识也越来越深入。但目前针对消化内科住院患者HP现症感染的研究报道相对较少,可能造成许多HP现症感染的病人常被临床医师忽略,导致HP的耐药性愈来愈强,根除治疗越来越难。同时,HP现症感染目前与消化系统很多疾病存在相关性,不仅是胃肠及胃肠外疾病,甚至消化系统外疾病也有一定的联系。为了更好地防治HP感染引起的相关性疾病,本研究针对上述问题,对成都军区昆明总医院消化内科住院患者进行了研究,旨在调查消化内科住院患者HP现症感染情况并分析相关因素,进而提出预防措施,更好地干预HP感染相关疾病。[方法]选取2011年10月～2015年5月在我院消化内科住院的患者共3684例,应用13C-尿素呼气试验(13C-Urea Breath Test)检测幽门螺杆菌现症感染情况,以年龄、性别和病种进行分组,分析不同状况下幽门螺杆菌的感染情况。[结果]1.对2011年10月～2015年5月间的3684例消化内科住院患者进行13C-尿素呼气试验检测,HP总的现症感染率为23.0%(848/3684),其中男性为23.5%,女性为22.4%,两组比较差异无统计学意义(P0.05)。2.从年龄分布来看,中年组的HP现症感染率(26.3%,322/1223)显著高于青年组(19.4%,160/664)(P0.01)和老年组(23.1%,378/1259)(P0.05),老年组也显著高于青年组(P0.05);呈现出随着年龄的增长,其感染率逐渐增高后又逐渐降低,在中年组中达到高峰。3.从性别分布来看,中年组中男性组及女性组HP现症感染率分别为28.7%(187/650)及23.6%(135/573),中年男性组HP现症感染率显著高于中年女性组,差异具有统计学意义(P0.05)。而青年组、老年组男性与女性HP现症感染率相比差异均无统计学意义(均P0.05)。4.从消化系统不同器官疾病间HP现症感染分布情况来看,上消化道疾病、下消化道疾病、肝胆疾病、胰腺疾病、腹腔疾病HP现症感染率分别为25.5%(646/2529)、20.3%(64/315)、19.0%(128/672)、10.4%(7/67)、3.0%(3/101),五组疾病HP现症感染率比较差异有统计学意义(P0.01),其中以上消化道疾病患者最高(P0.05)。5.从消化系统常见疾病间HP现症感染分布情况来看,HP现症感染率最高的5种疾病分别是消化性溃疡36.7%(166/452)、胃恶性肿瘤30.6%(19/32)、慢性胃炎26.1%(354/1354)、结肠恶性肿瘤25.9%(14/54)、结肠息肉25%(30/120),而胃食管返流病14.5%(20/138)最低。[结论]1.消化内科住院患者HP现症感染率较高,尤其在中年组中更高。呈现出随着年龄的增长,其感染率逐渐增高后又逐渐降低,在中年组中达到高峰。2.从不同年龄组的性别来看,中年组男性HP现症感染率显著高于女性组。3.上消化道疾病HP现症感染明显高于下消化道疾病。在下消化道疾病中,结肠恶性肿瘤、结肠息肉HP感染率也在不断增加,可能HP感染增加了结直肠肿瘤及结直肠息肉的发生风险,值得进一步关注。4.肝胆疾病、胰腺疾病等胃肠外疾病HP现症感染率较高,HP感染可能是肝胆、胰腺疾病的重要诱因之一,值得进一步关注。5.不同病种间的HP现症感染率不同,HP仍是消化性溃疡、慢性胃炎、胃恶性肿瘤的主要致病菌,而HP对胃食管反流病可能有保护作用。6.不同病种间的HP现症感染率不同,各有其不同的临床意义。
[Abstract]:[Objective] since the discovery of Helicoibacter pylori (HP) by Marshall and Warren, there are more and more researches on HP, and the understanding of it is becoming more and more in-depth. But at present, there are relatively few reports on the infection of HP present in the inpatients of digestive medicine, which may cause the patients with the present disease of Xu to be neglected by the clinicians and lead to H. The drug resistance of P is becoming stronger and stronger, and the eradication therapy is becoming more and more difficult. At the same time, the present infection of HP is associated with many digestive diseases, not only the gastrointestinal and gastrointestinal diseases, but also the digestive diseases. In order to better prevent and cure the related diseases caused by HP infection, this study is aimed at the above problems in the Chengdu army. The hospitalized patients in the digestive department of Kunming General Hospital of Kunming were studied. The purpose of this study was to investigate the current infection of the patients in the digestive department and analyze the related factors, and then put forward the preventive measures to better interfere with the HP infection related diseases. [Methods] 3684 patients hospitalized in the medicine department of our hospital from October 2011 to May 2015 were selected and 13C- urine was applied. 13C-Urea Breath Test (Test) was used to detect the present infection of Helicobacter pylori. The infection of Helicobacter pylori in different conditions was analyzed in groups with age, sex and disease. [results]1. test of 13C- urea breath test for 3684 hospitalized patients with digestive medicine from October 2011 to May 2015 and the present infection of HP The rate was 23% (848/3684), among which men were 23.5%, women were 22.4%, and there was no statistically significant difference between the two groups (P0.05).2. from the age distribution, the prevalence rate of HP in the middle age group (26.3%, 322/1223) was significantly higher than that in the young group (19.4%, 160/664) (P0.01) and the elderly group (23.1%, 378/1259) (P0.05), and the elderly group was also significantly higher than the young group (P0.05). With the increase of age, the infection rate gradually increased and decreased gradually. In the middle age group, the peak.3. from the middle age group was 28.7% (187/650) and 23.6% (135/573) in the middle age group and the female group, respectively. The prevalence rate of HP in middle age group was significantly higher than that in the middle age group, and the difference was statistically significant (the difference was statistically significant). P0.05). Compared with the young group, there was no significant difference in the prevalence of HP infection among the old men and women (P0.05). The infection rate of upper digestive tract disease, lower digestive tract disease, hepatobiliary disease, pancreatic disease, and abdominal disease HP was 25.5% (646/2529), 20.3% (646/2529), respectively, compared with the distribution of HP infection in different organs of the digestive system. (64/315), 19% (128/672), 10.4% (7/67), 3% (3/101), five groups of disease HP infection rates were significantly different (P0.01), of which the highest (P0.05).5. from the digestive system common disease among the common disease distribution of HP, the highest rate of HP infection rate of the 5 diseases were 36.7% of peptic ulcers (166/45, 36.7%) 2) gastric malignant tumor 30.6% (19/32), chronic gastritis 26.1% (354/1354), colon malignant tumor 25.9% (14/54), colon polyp 25% (30/120), and gastroesophageal reflux disease 14.5% (20/138) lowest. [conclusion]1. digestive internal medicine inpatients with higher HP present infection rate, especially in middle age group. With age increase, the infection rate gradually increases. In the middle age group, the peak value of.2. was higher than that in the different age groups. The prevalence rate of HP in the middle age group was significantly higher than that of the female group.3.. The infection rate of HP in the upper gastrointestinal tract was significantly higher than that of the lower digestive tract disease. In the lower digestive tract diseases, the colon malignant tumor, the HP infection rate of colon polyps were also increasing, and the possible HP infection was possible. To increase the risk of colorectal cancer and colorectal polyps, it is worth further attention to.4. liver and gallbladder disease, pancreatic disease and other gastrointestinal diseases, HP infection rate is high, HP infection may be one of the important causes of liver and gallbladder, pancreatic disease, it is worth further attention to the different diseases among different diseases of.5. infection rate of HP is different, HP is still peptic ulcer, Chronic gastritis, the main pathogenic bacteria of gastric malignant tumor, and HP may have protective effect on gastroesophageal reflux disease. The infection rate of HP between different diseases of.6. is different, each has its different clinical significance.

【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R573

【参考文献】