济南市区儿童慢性胃炎与消化性溃疡致病因素的流行病学调查

Epidemiology survey of chronic gastritis and peptic ulcer in children in urban district in Jinan

目的 探讨儿童慢性胃炎、消化性溃疡的致病因素及流行病学特点。方法 采取定群随机抽样的调查研究方法 ,首先采用问卷调查筛选出有上消化道症状的患儿 ,再行胃镜检查及幽门螺杆菌 (Hp)检测明确诊断 ,用SPSS统计软件统计处理。结果 济南市区儿童慢性胃炎、消化性溃疡患病率为 2 3 .2 7%和 3 .0 5 % ;Hp抗体总阳性率为 14 .72 %。病变类型以慢性浅表型胃炎为主 ,共 6型 ;症状极不典型 ,多于期末考试前后发病。病因调查结果为合并Hp感染的消化性溃疡 ( 3 4.0 0 % )高于慢性胃炎 ( 2 1.2 0 % ) ,两者比较有显著性差异 (P <0 .0 5 ) ;健康儿童、慢性胃炎、消化性溃疡组患儿Hp抗体总阳性率依次为 12 .5 3 %、16.75 %和 2 4.0 0 % ,三者比较无显著性差异 (P >0 .0 5 ) ;3组比较 ,食蔬菜、水果的百分率依次减少 ,食酸辣性食物的百分率依次增多。单亲、寄养、家庭不合睦、个体户家庭、择校、学习吃力及有家族史的百分率均依次升高 ,均为P <0 .0 5 ,有显著性差异 ;按危险度高低排序 ,慢性胃炎的致病因素依次为家庭不合睦、不吃水果、快速尿素酶试验阳性、父母文化层次低、CagA IgG阳性、学习吃力、单亲家庭、有家族史、不吃肉食。消化性溃疡致病因素依次为学习吃力、择校、爱吃冷食、CagA IgG阳性、有家族史。?

Objective To study the pathogenic factors and epidemiologic features of chronic gastritis and peptic ulcer in children. Methods Questionnaire was taken first with method of random sampling in fixed groups, then the patients screened with gastric symptoms were definitely diagnosed by gastroscopy and Helicobacter pylori (Hp) test. Results The incidence of chronic gastritis and peptic ulcer were respectively 23.27% and 3.05%, total positive rate of Hp antibody is 14.72%. There were six lesion types, chronic superficial gastritis was the dominant one. Symptoms were extremely atypical, the high attack was during the period before and after terminal examination. The rates with Hp infection was 34.00% in peptic ulcer, 21.20% in chronic gastritis, and there was significant difference between them (P<0.05). The total positive rates of Hp antibody in healthy children, chronic gastritis and peptic ulcer were respectively 12.55%, 16.75%, 24%, the difference was not significant (P>0.05). But the percentage of eating vegetable and fruits decreased and that of eating sour and hot food increased successively in the three groups. The percentage of children that lived in single-parent family, were brought up by other family, lived in inharmonious family, in self-employed individuals family, selected school, had difficulties in study and have family history of the diseases also increases successively in the three groups, the difference was significant ( P<0.05). The regression analysis showed that the pathogenic factors of chronic gastritis were successively living in inharmonious family, not eating fruits, rapid urease test positive, lower education levels of parents, CagA?IgG positive, having difficulties in study, not three-person family, having family history of the diseases, not eating meet etc. according to the risk and that of peptic ulcer successively having difficulties in study, selecting school, favorite in cold food, CagA?IgG positive, having family history. Conclusions Children are a group with high attack of chronic gastrointestinal diseases, most of them are chronic superficial gastritis, but the incidence of peptic ulcer is low. The symptoms are extremely atypical, the high attack is during the period before and after terminal examination. The pathogenic factor is a comprehensive factor dominated by social psychological one; the factor of Hp infection over-studied should be objectively recognized.