Compliance and influencing factors for endoscopic surveillance in patients with chronic atrophic gastritis: An analysis of 1 196 cases

GAO Zhi; WU Meng; CHEN Lei

doi:10.16016/j.2097-0927.202510014

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Compliance and influencing factors for endoscopic surveillance in patients with chronic atrophic gastritis: An analysis of 1 196 cases

Clinical Medicine | 更新时间：2025-12-30

- Compliance and influencing factors for endoscopic surveillance in patients with chronic atrophic gastritis: An analysis of 1 196 cases
- Journal of Army Medical University Vol. 47, Issue 24, Pages: 3120-3129(2025)
- 作者机构：
  
  陆军军医大学（第三军医大学）第一附属医院（西南医院）消化内科，重庆
- 作者简介：
  
  CHEN Lei， Email： xhl13228683896@tmmu.edu.cn
- 基金信息：
  
  the Chongqing Municipal Science-Health Joint Medical Research Program(2023ZDXM007)
- DOI：10.16016/j.2097-0927.202510014
  CLC： R195.4;R573;R573.32
- Received：11 October 2025，
  
  Revised：2025-12-06，
  
  Published：30 December 2025
- 稿件说明：
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高志，吴萌，陈磊.慢性萎缩性胃炎患者内镜随访监测依从性及其影响因素的分析［J］.陆军军医大学学报，2025，47（24）：3120-3129.DOI：10.16016/j.2097-0927.202510014.

GAO Z，WU M，CHEN L.Compliance and influencing factors for endoscopic surveillance in patients with chronic atrophic gastritis： An analysis of 1 196 cases［J］.J Army Med Univ，2025，47（24）：3120-3129.DOI：10.16016/j.2097-0927.202510014.
高志，吴萌，陈磊.慢性萎缩性胃炎患者内镜随访监测依从性及其影响因素的分析［J］.陆军军医大学学报，2025，47（24）：3120-3129.DOI：10.16016/j.2097-0927.202510014. DOI：

GAO Z，WU M，CHEN L.Compliance and influencing factors for endoscopic surveillance in patients with chronic atrophic gastritis： An analysis of 1 196 cases［J］.J Army Med Univ，2025，47（24）：3120-3129.DOI：10.16016/j.2097-0927.202510014. DOI：

摘要

目的

探讨慢性萎缩性胃炎（chronic atrophic gastritis，CAG）患者内镜随访监测依从性现状，并分析其影响因素。

方法

回顾性收集于2022年5月1日至2022年7月31日期间就诊于陆军军医大学第一附属医院消化内科并行胃镜检查诊断为CAG的患者病例信息（

=1 196），根据患者后续近3年在本院及外院的胃镜复查情况分为依从组（

=473）和非依从组（

=723），随访收集患者的一般人口学资料，幽门螺杆菌（Helicobacter pylori，H.pylori）感染阳性史、肠化史、萎缩分型等既往史，以及对于CAG的疾病认知、医院距离、医学背景等情况，分析内镜随访监测依从性现状，并采用单因素分析、Logistic回归分析评估患者胃镜复查依从性的独立影响因素，采用受试者工作特征（Receiver operating characteristic，ROC）曲线及ROC下面积（Area under the curve，AUC）来反映Logistic回归模型对于患者胃镜随访监测依从性的预测效果。

结果

本研究显示，在经胃镜诊断为CAG时，尽管接诊医生告知其2~3年内需要复查胃镜，但实际上只有473（39.55%）例患者后续遵医嘱复查胃镜，723（60.45%）例患者未复查。单因素分析发现：两组在居住地、教育程度、月收入、冠心病史、症状、H.pylori感染阳性史、肠化史、萎缩级别、疾病认知、健康意识评分、首次就诊科室、医院距离、医学背景上的差异均有统计学意义（

0.05）。Logistic回归分析显示：有疾病认知（

=6.280，95%

：4.442~8.878，

0.01）、健康意识评分（

=2.219，95%

：1.943~2.535，

0.01）越高、有症状（

=2.537，95%

：1.822~3.531，

0.01）、有H.pylori感染阳性史（

=2.159，95%

：1.496~3.116，

0.01）、有肠化史（

=3.452，95%

：2.100~5.675，

0.01）、有冠心病史（

=2.306，95%

：1.325~4.015，

0.01）的人群胃镜复查依从性高，月收入5 000~10 000元（

=2.525，95%

：1.693~3.766，

0.01）及10 000元以上（

OR=

4.268，95%

：2.472~7.370，

0.01）的人群依从性均高于月收入5000元以下的人群，O型萎缩（

=2.523，95%

：1.319~4.827，

0.01）的人群比C型萎缩的人群依从性高，首次就诊于消化内科（

=1.988，95%

：1.345~2.939，

0.01）的人群比就诊于其他科室的人群依从性高，医院距离（

=0.981，95%

：0.963~0.998，

0.05）越远，依从性越差；本专科及以上教育程度（

=0.250，95%

：0.138~0.453，

0.01）的人群比小学及以下教育程度人群依从性差，有医学背景（

=0.289，95%

：0.150~0.557，

0.01）的人群比无医学背景的人群依从性差。

结论

CAG患者内镜随访监测依从性与其对于CAG的疾病认知、健康意识评分、月收入、症状、H.pylori感染阳性史、肠化史、萎缩级别、首次就诊科室、冠心病史、医院距离、教育程度有关，临床医师可针对性制定个体化干预措施，以提升患者依从性，改善胃癌的预警效果。

Abstract

Objective

To investigate the current status of compliance with endoscopic follow-up in patients with chronic atrophic gastritis (CAG) and analyze its influencing factors.

Methods

Clinical data of 1 196 patients with gastroscopy-diagnosed CAG in our department from May 1 to July 31

2022 were retrospectively collected in this study. According to the status of gastroscopy reexamination in this hospital and other hospitals within the subsequent nearly 3 years

they were divided into a compliant group (

=473) and a non-compliant group (

=723). General demographic data of

and past medical history

including positive history of

Helicobacter pylori

(

H.pylori

) infection

intestinal metaplasia

and atrophy classification

as well as disease cognition of CAG

hospital distance

and medical background were collected during follow-up. The current status of compliance with endoscopic follow-up surveillance was analyzed. Univariate and logistic regression analyses were used to evaluate the independent influencing factors for patient compliance with gastroscopy reexamination

while receiver operating characteristic (ROC) curve and area under the curve (AUC) were adopted to determine the predictive efficiency of the logistic regression model on patient compliance with endosc

opic follow-up monitoring.

Results

Despite being advised by attending physicians to undergo reexamination within 2~3 years after CAG diagnosis

only 473 (39.55%) patients complied with the follow-up recommendation

while 723 (60.45%) patients did not. Univariate analysis showed statistical differences were observed between the 2 groups in terms of residence

education level

monthly income

history of coronary heart disease

symptoms

H. pylori

infection history

intestinal metaplasia history

atrophy grade

disease cognition

health awareness score

initial department of visit

hospital distance

and medical background (all

0.05). Logistic regression analysis revealed that the factors associated with higher compliance included having disease cognition (

=6.280

95%

: 4.442~8.878

0.01)

higher health awareness score (

=2.219

95%

: 1.943~2.535

0.01)

presence of symptoms (

=2.537

95%

: 1.822~3.531

0.01)

history of

H. pylori

infection (

=2.159

95%

: 1.496~3.116

0.01)

history of intestinal metaplasia (

=3.452

95%

: 2.100~5.675

0.01)

history of coronary heart disease (

=2.306

95%

: 1.325~4.015

0.01)

monthly income of 5 000~10 000 Yuan (

=2.525

95%

: 1.693~3.766

0.01) or ≥10 000 Yuan (

=4.268

95%

: 2.472~7.370

0.01) (both higher than those with monthly income

5 000 Yuan)

type O atrophy (

=2.523

95%

: 1.319~4.827

0.01) (higher than type C atrophy)

and initial visit to gastroenterological departme

nt (

=1.988

95%

: 1.345~2.939

0.01) (higher than visits to other departments). Conversely

longer hospital distance was associated with lower compliance (

=0.981

95%

: 0.963~0.998

0.05). The patients with college or higher education level (

=0.250

95%

: 0.138~0.453

0.01) had lower compliance than those with primary school education level or below

and those with medical background had lower compliance than those without (

=0.289

95%

: 0.150~0.557

0.01).

Conclusion

Compliance with endoscopic follow-up surveillance in CAG patients is associated with disease cognition of CAG

health awareness score

monthly income

symptoms

H. pylori

infection history

intestinal metaplasia history

atrophy grade

initial department of visit

history of coronary heart disease

hospital distance

and education level. Clinicians should formulate targeted individualized interventions to improve patient compliance and early warning for gastric cancer.

关键词

Keywords

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