近日，北京协和医院钱家鸣等研究人员合作完成，18至64岁中国成年人常见上消化道疾病的流行病学调查。相关论文于2024年11月5日在线发表于国际学术期刊《科学通报》。

为了调查18至64岁中国成年人胃食管反流病（GERD）、反流性食管炎（RE）、消化性溃疡胃溃疡（GU）、十二指肠溃疡（DU）和幽门螺杆菌（H. pylori）感染的流行情况及其相关因素，研究人员采用分层多阶段抽样方法，开展了一项基于社区的横断面研究。

研究中使用了标准化问卷调查、¹³C尿素呼气试验和胃镜检查。研究人员使用加权方法估计上述疾病或感染的流行率及其危险因素。最终，研究共纳入了2017至2018年间的27,637名18至64岁的参与者。

GERD、RE、GU、DU和H. pylori感染的流行率（95%置信区间）分别为10.5%（7.8%–14.2%）、5.4%（3.9%–7.3%）、2.5%（1.7%–3.7%）、4.5%（3.6%–5.4%）和41.5%（36.7%–46.4%）。H. pylori感染的比例在GU和DU患者中分别达到58.6%和61.1%。加权多变量逻辑回归模型显示，GERD、RE和GU具有共同的危险因素，如年龄和肥胖。

吸烟与这四种疾病之间存在剂量反应关系，饮酒与GERD及H. pylori感染之间也存在类似关系。中国西北地区的GERD（23.9%）、RE（8.7%）、GU（7.8%）、DU（7.3%）和H. pylori感染（63.6%）的流行率最高；然而，西南地区GU的流行率最高，但DU、RE和H. pylori感染的流行率最低。非甾体抗炎药与GERD的风险呈正相关。相反，在H. pylori感染患者中，服用该药物的GU风险较低。

总之，GERD、RE和H. pylori感染在中国的流行率仍然较高。根除H. pylori感染仍然是减少消化性溃疡疾病负担的首要任务。中国人口老龄化、超重或肥胖高发、吸烟和饮酒普遍，这些因素可能解释了这些疾病的高负担，因此，未来应采取针对性的上消化道疾病预防措施。

附：英文原文

Title: Prevalence of common upper gastrointestinal diseases in Chinese adults aged 18–64 years

Author: Limin Wang b, Li Wang c, Jiaming Qian a

Issue&Volume: 2024/11/05

Abstract: To investigate the prevalence of gastroesophageal reflux disease (GERD), reflux esophagitis (RE), digestive ulcer gastric ulcer (GU), duodenal ulcer (DU), and Helicobacter pylori infection in Chinese adults aged 18–64 years and their associated factors, a community-based cross-sectional study using a stratified multistage sampling method was conducted. A standardized questionnaire survey, the 13C-urea breath test, and gastroscopy were performed. Weighted methods were used to estimate the prevalence of diseases or infection mentioned above and their risk factors. Finally, 27,637 participants aged 18–64 years were enrolled from 2017 to 2018. The prevalence (95% confidence interval) of GERD, RE, GU, DU, and H. pylori infection was estimated to be 10.5% (7.8%–14.2%), 5.4% (3.9%–7.3%), 2.5% (1.7%–3.7%), 4.5% (3.6%–5.4%), and 41.5% (36.7%–46.4%), respectively. The fraction of H. pylori infection reached 58.6% and 61.1% among the GU and DU patients, respectively. Weighted multivariable logistic regression models showed that GERD, RE, and GU shared the common risk factors of age and obesity. Dose-response relationships were observed between smoking and all four diseases, as well as alcohol consumption and GERD and H. pylori infection. Northwest China had the highest prevalence of GERD (23.9%), RE (8.7%), GU (7.8%), DU (7.3%), and H. pylori infection (63.6%); however, the southwest region had the highest prevalence of GU but the lowest of DU, RE, and H. pylori infection. Non-steroidal anti-inflammatory drugs were positively associated with GERD risk. On the contrary, a reduced risk of GU was observed among H. pylori-infected patients taking this drug. In summary, the prevalence of GERD, RE, and H. pylori infection still appears high in China. H. pylori infection eradication remains the priority to reduce the burden of peptic ulcer disease. The aging population, high prevalence of overweight or obesity, smoking, and drinking in China could explain the high burden of these diseases, thus suggesting the targeted preventive measures for upper gastrointestinal diseases in the future.

DOI: 10.1016/j.scib.2024.07.048

Source: https://www.sciencedirect.com/science/article/abs/pii/S2095927324007977