2 research outputs found
Prevalence of Helicobacter pylori-associated diseases in the Ural Federal District
Introduction Helicobacter pylori has the most pronounced oncogenic potential among known biological carcinogens of humans. Helicobacter positivity leads to the development of chronic gastritis and with prolonged persistence of infection in the gastric mucosa it is associated with the development of atrophic gastritis and adenocarcinoma of the stomach. According to international data, the prevalence of infection in Russia corresponds to the level of countries with low socio-economic status. The domestic literature contains data for a limited number of regions, such as North-West Russia, Siberia and the Far East. The aim of the study was to determine the prevalence of Helicobacter pylori infection and chronic atrophic gastritis among patients residing in the Ural Federal District and to identify risk factors for these diseases using modern diagnostic methods used in clinical practice. Materials and methods Observational non-interventional anonymous cross-sectional study of 11,721 primary patients among those tested for H. pylori infection residing in the Ural Federal District. 13C-urease breath test was performed in 10,882 patients, FGDS with gastric mucosal biopsy according to OLGA and histological evaluation of biopsy specimens β in 839 patients. Results The prevalence of H. pylori infection among primary care patients by 13C-UT was 46.9 % and that of chronic atrophic gastritis by histological evaluation of a biopsy specimen was 24.9 %. The risk of chronic atrophic gastritis was higher in those infected with H. pylori (OR 1.71; 95 % CI: 1.24β2.37, p = 0.002) and in patients over 60 years old. Discussion The resulting prevalence of H. pylori infection in the Ural Federal District is below the levels reported in the current literary for Russia. The increasing prevalence of infection with age confirms the principle that the prevalence of infection depends on changing socio-economic conditions in a generation. The observed prevalence of chronic atrophic gastritis is comparable with the national data. The risk of gastric mucosal atrophy increases with age and in the presence of H. pylori infection, which prompts active screening of gastropathology in this category of individuals. Conclusion The prevalence of H. pylori infection and atrophic gastritis among primary patients, as determined by reference diagnostics, was 46.9 % and 24.9 %, respectively.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΠ°ΠΊΡΠ΅ΡΠΈΡ Helicobacter pylori ΠΎΠ±Π»Π°Π΄Π°Π΅Ρ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΡΠΌ ΠΎΠ½ΠΊΠΎΠ³Π΅Π½Π½ΡΠΌ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»ΠΎΠΌ ΡΡΠ΅Π΄ΠΈ ΠΈΠ·Π²Π΅ΡΡΠ½ΡΡ
Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΊΠ°Π½ΡΠ΅ΡΠΎΠ³Π΅Π½ΠΎΠ² ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ°. ΠΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΠΉ Ρ
Π΅Π»ΠΈΠΊΠΎΠ±Π°ΠΊΡΠ΅ΡΠ½ΡΠΉ ΡΡΠ°ΡΡΡ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π³Π°ΡΡΡΠΈΡΠ° ΠΈ ΠΏΡΠΈ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΠΏΠ΅ΡΡΠΈΡΡΠ΅Π½ΡΠΈΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ Π² ΡΠ»ΠΈΠ·ΠΈΡΡΠΎΠΉ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠ΅ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ° Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½ Ρ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ΠΌ Π°ΡΡΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π³Π°ΡΡΡΠΈΡΠ° ΠΈ Π°Π΄Π΅Π½ΠΎΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌΡ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ°. ΠΠΎ ΠΌΠ΅ΠΆΠ΄ΡΠ½Π°ΡΠΎΠ΄Π½ΡΠΌ Π΄Π°Π½Π½ΡΠΌ, ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ Π² Π ΠΎΡΡΠΈΠΈ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΠ΅Ρ ΡΡΠΎΠ²Π½Ρ ΡΡΡΠ°Π½ Ρ Π½ΠΈΠ·ΠΊΠΈΠΌ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΡΠ°ΡΡΡΠΎΠΌ. Π ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΉ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ΅ ΠΏΡΠΈΡΡΡΡΡΠ²ΡΡΡ Π΄Π°Π½Π½ΡΠ΅ Π΄Π»Ρ ΠΎΠ³ΡΠ°Π½ΠΈΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΡΠΈΡΠ»Π° ΡΠ΅Π³ΠΈΠΎΠ½ΠΎΠ²: Π‘Π΅Π²Π΅ΡΠΎ-ΠΠ°ΠΏΠ°Π΄Π½ΠΎΠΉ ΡΠ°ΡΡΠΈ Π ΠΎΡΡΠΈΠΈ, Π‘ΠΈΠ±ΠΈΡΠΈ ΠΈ ΠΠ°Π»ΡΠ½Π΅Π³ΠΎ ΠΠΎΡΡΠΎΠΊΠ°. Π¦Π΅Π»Ρ ΡΠ°Π±ΠΎΡΡ β ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ Helicobacter pylori ΠΈ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°ΡΡΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π³Π°ΡΡΡΠΈΡΠ° ΡΡΠ΅Π΄ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΡΠΎΠΆΠΈΠ²Π°ΡΡΠΈΡ
Π² Π£ΡΠ°Π»ΡΡΠΊΠΎΠΌ ΡΠ΅Π΄Π΅ΡΠ°Π»ΡΠ½ΠΎΠΌ ΠΎΠΊΡΡΠ³Π΅, ΠΈ Π²ΡΡΠ²ΠΈΡΡ ΡΠ°ΠΊΡΠΎΡΡ ΡΠΈΡΠΊΠ° Π΄Π°Π½Π½ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ ΠΏΠΎΡΡΠ΅Π΄ΡΡΠ²ΠΎΠΌ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ, ΠΏΡΠΈΠΌΠ΅Π½ΡΠ΅ΠΌΡΡ
Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ±ΡΠ΅ΡΠ²Π°ΡΠΈΠΎΠ½Π½ΠΎΠ΅ Π½Π΅ΠΈΠ½ΡΠ΅ΡΠ²Π΅Π½ΡΠΈΠΎΠ½Π½ΠΎΠ΅ Π°Π½ΠΎΠ½ΠΈΠΌΠ½ΠΎΠ΅ ΠΊΡΠΎΡΡ-ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ 11 721 ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠ³ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°. ΠΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ, ΠΏΡΠΎΡ
ΠΎΠ΄ΠΈΠ²ΡΠΈΠ΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π½Π° ΠΈΠ½ΡΠ΅ΠΊΡΠΈΡ H. pylori, ΠΏΡΠΎΠΆΠΈΠ²Π°Π»ΠΈ Π½Π° ΡΠ΅ΡΡΠΈΡΠΎΡΠΈΠΈ Π£ΡΠ°Π»ΡΡΠΊΠΎΠ³ΠΎ ΡΠ΅Π΄Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΠΊΡΡΠ³Π°. 13Π‘-ΡΡΠ΅Π°Π·Π½ΡΠΉ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΡΠΉ ΡΠ΅ΡΡ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ 10 882 Π±ΠΎΠ»ΡΠ½ΡΠΌ, Π€ΠΠΠ‘ Ρ Π±ΠΈΠΎΠΏΡΠΈΠ΅ΠΉ ΡΠ»ΠΈΠ·ΠΈΡΡΠΎΠΉ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠΈ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ° ΠΏΠΎ OLGA (Π°Π½Π³Π». Operative Link for Gastritis Assessment) ΠΈ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΎΠΉ Π±ΠΈΠΎΠΏΡΠ°ΡΠΎΠ² β 839 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π Π°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ H. pylori ΡΡΠ΅Π΄ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎ ΠΎΠ±ΡΠ°ΡΠΈΠ²ΡΠΈΡ
ΡΡ Π·Π° ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΡΡ, ΠΏΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ 13Π‘-Π£ΠΠ’ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 46,9 %, Π° Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°ΡΡΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π³Π°ΡΡΡΠΈΡΠ° ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ Π±ΠΈΠΎΠΏΡΠ°ΡΠ° β 24,9 %. Π ΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°ΡΡΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π³Π°ΡΡΡΠΈΡΠ° Π²ΡΡΠ΅ Ρ Π»ΠΈΡ, ΠΈΠ½ΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
H. pylori (ΠΠ¨ 2,25; 95 % ΠΠ:1,62β3,11, Ρ < 0,001), ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΡΠ°ΡΡΠ΅ 60 Π»Π΅Ρ. ΠΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. ΠΠΎΠ»ΡΡΠ΅Π½Π½Π°Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ H. pylori Π² Π£ΡΠ°Π»ΡΡΠΊΠΎΠΌ ΡΠ΅Π΄Π΅ΡΠ°Π»ΡΠ½ΠΎΠΌ ΠΎΠΊΡΡΠ³Π΅ Π½ΠΈΠΆΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π½ΡΡ
Π² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ½ΡΡ
ΠΈΡΡΠΎΡΠ½ΠΈΠΊΠ°Ρ
ΡΡΠΎΠ²Π½Π΅ΠΉ Π΄Π»Ρ Π ΠΎΡΡΠΈΠΈ. ΠΠ°ΡΠ°ΡΡΠ°Π½ΠΈΠ΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ Ρ Π²ΠΎΠ·ΡΠ°ΡΡΠΎΠΌ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π°Π΅Ρ ΠΏΡΠΈΠ½ΡΠΈΠΏ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ ΠΎΡ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ»ΠΎΠ²ΠΈΠΉ ΠΆΠΈΠ·Π½ΠΈ ΠΏΠΎΠΊΠΎΠ»Π΅Π½ΠΈΡ. ΠΡΡΠ²Π»Π΅Π½Π½Π°Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°ΡΡΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π³Π°ΡΡΡΠΈΡΠ° ΡΠΎΠΏΠΎΡΡΠ°Π²ΠΈΠΌΠ° Ρ ΠΎΡΠ΅ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΌΠΈ Π΄Π°Π½Π½ΡΠΌΠΈ. Π ΠΈΡΠΊ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π°ΡΡΠΎΡΠΈΠΈ ΡΠ»ΠΈΠ·ΠΈΡΡΠΎΠΉ ΠΎΠ±ΠΎΠ»ΠΎΡΠΊΠΈ ΠΆΠ΅Π»ΡΠ΄ΠΊΠ° ΠΏΠΎΠ²ΡΡΠ°Π΅ΡΡΡ Ρ Π²ΠΎΠ·ΡΠ°ΡΡΠΎΠΌ ΠΈ ΠΏΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ H. pylori, ΡΡΠΎ ΠΏΠΎΠ±ΡΠΆΠ΄Π°Π΅Ρ ΠΊ Π°ΠΊΡΠΈΠ²Π½ΠΎΠΌΡ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³Ρ Π³Π°ΡΡΡΠΎΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Ρ Π΄Π°Π½Π½ΠΎΠΉ ΠΊΠ°ΡΠ΅Π³ΠΎΡΠΈΠΈ Π»ΠΈΡ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π Π°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ H. pylori ΠΈ Π°ΡΡΠΎΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π³Π°ΡΡΡΠΈΡΠ° ΡΡΠ΅Π΄ΠΈ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½Π°Ρ Π½Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ΅ΡΠ΅ΡΠ΅Π½ΡΠ½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ, ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 46,9 % ΠΈ 24,9 % ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ