Abstract: Objective　To explore the risk factors of chronic gastritis (CG) and peptic ulcer (PU) in children in the Yellow River Delta area. Methods　A total of 542 children with CG and 92 children with PU were selected from Binzhou Medical University Hospital from January 2019 to December 2021 as experimental groups (CG group and PU group), and 260 healthy children were enrolled as a control group. A questionnaire-based survey was conducted for all children, and all risk factors were screened. The factors with P<0.2 in the univariate analysis were introduced into the logistic regression model, a multivariate regression analysis was conducted to calculate the odds ratio (OR) of each factor, and the risk factors were ranked according to the OR value from high to low. Independent sample t test was used for the measurement data, and chi-square test was used for the count data. Results　In the CG group, there were 283 males and 259 females, with an age of (8.506±3.482) years old; in the PU group, there were 42 males and 50 females, with an age of (8.728±3.803) years old; in the control group, there were 147 males and 113 females, with an age of (8.004±3.458) years old. According to the results of univariate analysis, 26 factors were identified for CG and 25 factors for PU. Among them, 13 pathogenic factors for CG in children were shown by multivariate logistic regression analysis. According to the OR value, the 13 factors in the descending order were "mental stress", "strenuous activity after eating", "parental anxiety", "single-parent family", "eating snacks", "eating meat", "overeating", "learning difficulties", "living in the countryside", "voracious eating", "family history", "Helicobacter pylori (Hp) infection (virulent type)", and "eating take-out food / small dining table" (all OR>1, P<0.05). Five protective factors were identified for CG, which were "eating fruits", "having their own bedrooms", "having their own tableware", "eating vegetables", and "adding supplement food at 4-6 months" (all OR<1, P<0.05). Eight risk factors were screened for PU, and the factors in the descending order were "Hp infection (virulent type)", "family history", "eating midnight snacks", "eating snacks", "living in the countryside", "eating take-out food / small dining table", "eating meat", and "Hp infection (weak virulence type)" (all OR>1, P<0.05); "having their own tableware" and "eating vegetables" were the protective factors (both OR<1, P<0.05). Conclusions　CG and PU in children are the results of multiple risk factors. In the Yellow River Delta area, psychological factors and diet-related factors are the main risk factors for CG in children, while Hp infection, family history, and diet-related factors are the main risk factors for PU in children.

Key words: Chronic gastritis, Peptic ulcer, Children, Risk factors, Regression analysis

摘要： 目的　探究黄河三角洲地区儿童慢性胃炎（CG）、消化性溃疡（PU）的致病危险因素。方法　选择2019年1月至2021年12月滨州医学院附属医院542例CG患儿、92例PU患儿作为试验组，260例健康儿童作为对照组。对所有儿童进行问卷调查，对所有危险因素进行筛选，将在单因素分析中P<0.2的因素引入多因素logistic回归模型，计算各个因素危险度，并按危险度由高到低进行排名。计量资料采用独立样本t检验，计数资料采用卡方检验。结果　CG组男283例，女259例，年龄（8.506±3.482）岁；PU组男42例，女50例，年龄（8.728±3.803）岁；对照组男147例，女113例，年龄（8.004±3.458）岁。32项单因素中，CG、PU分别筛选可疑单因素26项和25项。进一步logistic回归分析发现，儿童CG有13项致病危险因素，按危险度由高到低依次是“精神压力大”“饮食后剧烈活动”“父母焦虑”“单亲家庭”“爱吃零食”“爱吃肉”“暴饮暴食”“学习困难”“居住在农村”“狼吞虎咽”“有家族史”“幽门螺杆菌（Hp）感染（强毒力型）”“吃外卖/小饭桌”（均OR>1，P<0.05）；另有5项保护性因素，依次是“爱吃水果”“有独立卧室”“有单独餐具”“爱吃蔬菜”“4～6个月添加辅食”（均OR<1，P<0.05）。儿童PU有8项危险因素，按危险度由高到低依次是“Hp感染（强毒力型）”“有家族史”“吃夜宵”“爱吃零食”“居住在农村”“吃外卖/小饭桌”“爱吃肉”“Hp感染（弱毒力型）”（均OR>1，P<0.05），另外2项“有单独餐具”“爱吃水果”为保护性因素（均OR<1，P<0.05）。结论　儿童CG、PU是多种因素共同影响的结果；在黄河三角洲地区，精神心理因素、饮食相关因素是CG主要致病危险因素，而Hp感染、家族史、饮食相关因素是PU主要危险因素。

关键词: 慢性胃炎, 消化性溃疡, 儿童, 危险因素, 回归分析