未感染幽门螺杆菌的慢性萎缩性胃炎临床特征与代谢综合征的关系  

Clinical features of chronic atrophic gastritis in patients without Helicobacter pylori infection and its association with metabolic syndrome

作　　者：李夏薇 李昊峰 兰春慧 陈东风 郭严 Li Xiawei;Li Haofeng;Lan Chunhui;Chen Dongfeng;Guo Yan(Department of Gastroenterology,Army Medical Center of PLA(Chongqing Daping Hospital),Chongqing 400042,China)

机构地区：[1]解放军陆军特色医学中心(重庆大坪医院)消化内科,重庆400042

出　　处：《中华消化杂志》2024年第6期368-372,共5页Chinese Journal of Digestion

基　　金：重庆市面上基金项目(cstc2021jcyj-msxmX0451)。

摘　　要：目的探索未感染幽门螺杆菌(H.pylori)的慢性萎缩性胃炎(CAG)的临床特征与代谢综合征的关系。方法纳入2022年6月1日至2023年3月31日于解放军陆军特色医学中心(重庆大坪医院)诊断为CAG的患者966例。所有患者均接受14C尿素呼气试验和胃镜检查,分为感染组(461例,即感染H.pylori的CAG患者)和未感染组(505例,即未感染H.pylori的CAG患者)。收集并比较两组相关资料,包括年龄、体重指数、胃萎缩程度(木村-竹本分型),以及代谢综合征、糖尿病、高脂血症情况。统计学方法采用独立样本t检验和卡方检验。采用多元线性回归分析未感染组患者相关指标与胃萎缩程度的相关性。结果未感染组中71~80岁患者占比高于感染组[17.0%(86/505)比10.4%(48/461)],差异有统计学意义(χ^(2)=9.62,P=0.002)。对比两组患者的胃萎缩程度,未感染组的闭合型-1、闭合型-2患者占比均高于感染组[53.5%(270/505)比46.4%(214/461)、34.1%(172/505)比26.2%(121/461)],差异均有统计学意义(χ^(2)=4.78、6.96,均P<0.05)。未感染组中代谢综合征、糖尿病、高脂血症和肥胖(体重指数≥28 kg/m 2)患者占比均高于感染组[31.2%(20/64)比14.8%(9/61)、33.5%(62/185)比21.5%(34/158)、31.3%(67/214)比7.8%(36/461)、36.7%(22/60)比19.7%(12/61)],差异均有统计学意义(χ^(2)=4.77、6.08、4.95、4.32,均P<0.05)。多元线性回归分析显示,高密度脂蛋白胆固醇、血糖和体重指数均与胃萎缩程度相关(r=-0.15、0.20、0.31,均P<0.05)。结论未感染H.pylori的CAG可能与生理性衰老有关,胃萎缩程度集中为闭合型-1和闭合型-2,与代谢综合征相关。ObjectiveTo explore the clinical features of chronic atrophic gastritis(CAG)without Helicobacter pylori(H.pylori)infection and its correlation with metabolic syndrome.MethodsFrom June 1,2022 to March 31,2023,a total of 966 patients diagnosed with CAG at Army Medical Center of PLA(Chongqing Daping Hospital)were enrolled.All the patients underwent 14C-urea breath test and gastroscopy.The patients were divided into infected group(461 patients with H.pylori-positive CAG)and uninfected group(505 patients with H.pylori-negative CAG).Relevant data including age,body mass index,degree of gastric atrophy(Kimura-Takemoto classification),metabolic syndrome,diabetes mellitus,and hyperlipidemia were collected and compared between the 2 groups.Independent sample t-test and chi-square test were used for statistical analysis.Multiple linear regression analysis was performed to investigate the correlation between relevant indicators and the degree of gastric atrophy in the uninfected group patients.ResultsThe proportion of patients aged 71 to 80 years old in the uninfected group was higher than that in the infected group(17.0%,86/505 vs.10.4%,48/461),and the difference was statistically significant(χ^(2)=9.62,P=0.002).The degree of gastric atrophy was compared between the 2 groups,the proportions of C1 and C2 patients in the uninfected group were higher than those in the infected group(53.5%,270/505 vs.46.4%,214/461;34.1%,172/505 vs.26.24%,121/461),and the differences were statistically significant(χ^(2)=4.78 and 6.96,both P<0.05).The proportions of patients with metabolic syndrome,diabetes mellitus,hyperlipidemia and obesity in the uninfected group were higher than those in the infected group(31.2%,20/64 vs.14.8%,9/61;33.5%,62/185 vs.21.5%,34/158;31.3%,67/214 vs.7.8%,36/461;36.7%,22/60 vs.19.7%,12/61),and the differences were statistically significant(χ^(2)=4.77,6.08,4.95,and 4.32,all P<0.05).The results of multiple linear regression analysis showed that high density lipoprotein-cholesterol,blood glucose,and body mass index w

关 键 词：幽门螺杆菌感染 慢性萎缩性胃炎 衰老 胃肿瘤 

分 类 号：R573.32[医药卫生—消化系统]