幽门螺杆菌易感因素分析及感染风险预测模型的构建  

Analysis of susceptibility factors and construction of infection risk prediction model for Helicobacter pylori

作　　者：陈虎 陈光侠 余思锦 刘敏[3] 赵辛欣 黄思惠 刘世育 CHEN Hu;CHEN Guangxia;YU Sijin;LIU Min;ZHAO Xinxin;HUANG Sihui;LIU Shiyu(Department of Gastroenterology,the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University,Jiangsu Province,Xuzhou221000,China;the First Clinical College,Xuzhou Medical University,Jiangsu Province,Xuzhou221004,China;School of Chemical Engineering&Technology,China)

机构地区：[1]徐州医科大学附属徐州市立医院消化内科,江苏徐州221000 [2]徐州医科大学第一临床学院,江苏徐州221004 [3]中国矿业大学化工学院,江苏徐州221116

出　　处：《中国医药导报》2024年第30期135-140,共6页China Medical Herald

基　　金：江苏省徐州市医学领军人才培养项目(XWR CHT20210025);江苏省徐州市重点研发计划(社会发展)项目(KC22095、KC22111);江苏省徐州市卫生健康委员会科技项目(XWKYHT20220073)。

摘　　要：目的分析地区人群感染幽门螺杆菌(Hp)的高危因素,同时制作列线图用于预测个体感染Hp的风险。方法收集2022年7月至2023年7月于徐州医科大学附属徐州市立医院消化内镜中心行^(13)C呼气试验的677例患者的相关资料,根据检测结果将患者分为Hp感染组(422例)与Hp未感染组(255例),采用单因素分析比较两组人群在一般信息、生活及饮食习惯、慢性病史、家庭同住成员情况方面的差异,并采用多因素logistic回归分析人群感染相关独立影响因素。随后基于多因素分析结果,使用R 4.3.2软件及配套的RStudio软件制作列线图模型。结果单因素分析结果显示,两组性别、年龄、受教育程度、长期居住地、主要食物来源、手卫生习惯、餐具使用、家庭成员感染、慢性胃炎、慢性萎缩性胃炎及消化性溃疡病史方面比较,差异有统计学意义(P<0.05)。多因素分析结果显示,年龄(>30~45、>45~60、>60~80,OR=1.192、0.946、0.479,95%CI:0.662~2.149、0.518~1.728、0.233~0.986,P=0.558、0.858、0.046)、家庭成员感染情况(OR=12.397,95%CI:6.036~25.461,P<0.001)、长期居住地(OR=4.622,95%CI:2.669~8.004,P<0.001)、慢性胃炎(OR=2.201,95%CI:1.382~3.506,P=0.001)及慢性萎缩性胃炎患病情况(OR=3.939,95%CI:1.511~10.270,P=0.005)是Hp感染的独立影响因素。基于上述独立影响因素构建的列线图模型在预测Hp感染风险时的受试者操作特征曲线的曲线下面积为0.777(95%CI:0.743~0.811)。结论Hp感染与患者年龄较轻、居住农村、家庭成员存在感染、有慢性胃炎和/或慢性萎缩性胃炎病史密切相关,研究构建的列线图模型能够有效预测患者Hp感染风险。Objective To analyze the high risk factors of Helicobacter pylori(Hp)infection in local population,and to make a nomogram for predicting the risk of individual Hp infection.Methods The relevant data of 677 patients who underwent^(13)C breath test at the Digestive Endoscopy Center,the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University from July 2022 to July 2023 were collected.According to the test results,the patients were divided into Hp infected group(422 cases)and Hp uninfected group(255 cases).Univariate analysis was used to compare the differences between the two groups in general information,living and eating habits,chronic medical history,and family members,and multivariate logistic regression was used to analyze the independent influencing factors related to population infection.Then,based on the results of multi-factor analysis,R 4.3.2 software and the accompanying RStudio software were used to make the nomogram model.Results Univariate analysis showed that there were statistically significant differences in gender,age,education level,long-term residence,main food sources,hand hygiene habits,tableware use,family member infection,chronic gastritis,chronic atrophic gastritis,and peptic ulcer history between the two groups(P<0.05).Multivariate analysis showed that age(>30-45,>45-60,>60-80,OR=1.192,0.946,0.479,95%CI:0.662-2.149,0.518-1.728,0.233-0.986,P=0.558,0.858,0.046),infection status of family members(OR=12.397,95%CI:6.036-25.461,P<0.001),long-term residence(OR=4.622,95%CI:2.669-8.004,P<0.001),chronic gastritis(OR=2.201,95%CI:1.382-3.506,P=0.001)and the prevalence of chronic atrophic gastritis(OR=3.939,95%CI:1.511-10.270,P=0.005)were independent influencing factors for Hp infection.The area under the curve of the receiver operating characteristic curve of the nomogram model based on the above independent influencing factors was 0.777(95%CI:0.743-0.811)when predicting the risk of Hp infection.Conclusion Hp infection is closely related to young age,rural residence,infection in family member

关 键 词：幽门螺杆菌 易感因素 列线图 预测模型 

分 类 号：R573.9[医药卫生—消化系统]