幽门螺杆菌感染与进展期结直肠腺瘤的相关性分析  

Correlation analysis between Helicobacter pylori infection and advanced colorectal adenoma

作　　者：张永霞 张娜 徐丽婷 张彦清 李强[2] 郑亚 熊鑫堂 路红[2] ZHANG Yongxia;ZHANG Na;XU Liting;ZHANG Yanqing;LI Qiang;ZHENG Ya;XIONG Xintang;LU Hong(The First Clinical Medical College of Lanzhou University,Lanzhou 730000,China;Department of Gastroenterology,the First Hospital of Lanzhou University,Lanzhou 730000,China;Clinical Research Center of Digestive Diseases of Gansu Province,the First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,730000 [2]兰州大学第一医院消化科,730000 [3]兰州大学第一医院甘肃省消化系疾病临床研究中心,730000

出　　处：《现代消化及介入诊疗》2024年第10期1168-1172,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：甘肃省级自然基金项目(23JRRA0944)。

摘　　要：目的探讨幽门螺杆菌感染与进展期结直肠腺瘤的相关性,为结直肠腺瘤的预防和治疗提供依据。方法研究对象为2023年4月至2024年2月在兰州大学第一医院消化科住院部就诊、年龄≥18岁的134例结直肠腺瘤患者,收集14 C尿素呼气试验、血清幽门螺杆菌抗体分型检测幽门螺杆菌感染情况,根据结肠镜检查结果将患者分为进展期结直肠腺瘤组(n=69)、非进展期结直肠腺瘤组(n=65),收集患者的临床资料,通过t检验、χ^(2)检验、秩和检验及多因素logistic回归分析幽门螺杆菌感染与进展期结直肠腺瘤之间的相关性。结果结直肠腺瘤患者中,幽门螺杆菌阳性率为46.27%,幽门螺杆菌阳性组患者进展期腺瘤、腺瘤直径≥1 cm比例均大于幽门螺杆菌阴性组,血清胃蛋白酶原Ⅰ、胃蛋白酶原Ⅱ、胃泌素17水平均高于幽门螺杆菌阴性组,胃蛋白酶原Ⅰ/Ⅱ水平低于幽门螺杆菌阴性组(P<0.05)。通过对未感染、现症感染、既往感染三种不同幽门螺杆菌感染状态下进展期腺瘤患病率比较后发现,现症感染组与未感染组患者进展期腺瘤患病率比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,幽门螺杆菌阳性组患者进展期腺瘤患病风险是幽门螺杆菌阴性组的2.32倍(比值比为2.32;95%置信区间为:1.13~4.77,P=0.021);幽门螺杆菌抗体Ⅰ型组患者进展期腺瘤患病风险是幽门螺杆菌抗体阴性组的2.19倍(比值比为2.19;95%置信区间为:1.02~4.72,P=0.044)。结论幽门螺杆菌感染是进展期结直肠腺瘤的危险因素,预防幽门螺杆菌感染并及时根除对进展期结直肠腺瘤的防治有一定的临床意义。Objective To explore the correlation between Helicobacter pylori infection and advanced colorectal adenoma and to provide evidence for the prevention and treatment of colorectal adenoma.Methods The study subjects were 134 patients with colorectal adenoma aged≥18 years who were admitted to the inpatient Department of Gastroenterology,the First Hospital of Lanzhou University from April 2023 to February 2024.14 C urea breath test and serum antibody typing of Helicobacter pylori were collected to detect Helicobacter pylori infection.According to colonoscopy results,the patients were divided into advanced colorectal adenoma group(n=69)and non-advanced colorectal adenoma group(n=65).Collect patient′s clinical data,The correlation between Helicobacter pylori infection and advanced colorectal adenoma was analyzed by t test,χ^(2) test,rank-sum test and multivariate logistic regression.Results The prevalence of Helicobacter pylori infection in colorectal adenoma patients was 46.27%.The proportions of advanced adenoma,adenoma with a diameter of≥1 cm in Helicobacter pylori positive group were higher than those in Helicobacter pylori negative group,and the levels of serum pepsinogen I,pepsinogen II,gastrin 17 in Helicobacter pylori positive group were higher than those in Helicobacter pylori negative group,the level of pepsinogen I/II was lower than that of Helicobacter pylori negative group(P<0.05).After compariing the prevalence of advanced adenoma in three different Helicobacter pylori infection states:uninfected,current infection and past infection,it was found that the prevalence of advanced adenoma in the current infection group and the uninfected group had statistical significance(P<0.05).Multivariate logistic regression analysis showed that the risk of advanced adenoma in Helicobacter pylori positive group was 2.32 times higher than that in Helicobacter pylori negative group(odds ratio=2.32;95%confidence interval:1.13~4.77,P=0.021).The risk of advanced adenoma in Helicobacter pylori antibody type I was 2.19 tim

关 键 词：幽门螺杆菌 进展期结直肠腺瘤 胃泌素 胃蛋白酶原 

分 类 号：R735.34[医药卫生—肿瘤] R574[医药卫生—临床医学]