幽门螺杆菌与小儿慢性胃炎的研究

A study on association of helicobacter pylori with chronic gastritis in children

为探讨幽门螺杆菌（ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ，Ｈｐ）与小儿慢性胃炎关系，应用细菌培养及组织病理学技术，对７３例具有消化道症状行胃镜检查患儿胃粘膜标本进行研究，并测定患儿血清抗幽门螺杆菌抗体ＨｐＩｇＧ、ＨｐＩｇＡ。结果显示，７３例患儿中Ｈｐ总检出率为３７％（２７／７３），在慢性胃炎者中检出率为４４％（２７／６１），与组织学检查正常者比较差异有非常显著意义（精确概率Ｐ＝０．００２１）；Ｈｐ的检出与胃粘膜炎症程度相关，表明Ｈｐ可能是慢性胃炎的一种致病因素。细菌学Ｈｐ阳性组和阴性组ＨｐＩｇＧ、ＨｐＩｇＡ抗体水平比较，阳性组高于阴性组，差异有非常显著意义（ｔ＝６．９３６，Ｐ＜０．０１）。提示与胃粘膜Ｈｐ检查相对照，ＨｐＩｇＧ有较好的敏感性、特异性，有助于Ｈｐ感染的诊断，ＨｐＩｇＡ抗体水平在两组间重叠较多。

To determine whether helicobacter pylori (HP) could be detected on the gastric mucosa of children in our country and the relationship between this organism and chronic gastritis, the authors prospectively studied both microbiologically and histologically the gastric biopsy specimens of 73 children who presented upper gastrointestinal symptoms and underwent fiberoptic gastriscopy. The authors also established an ELISA method to measure Hp IgG and IgA antibodies in 69 patients. The results showed that (1) out of 73 patients with upper gastrointestinal symptoms, Hp was identified in 37.0% (27/73), of whom 12 were histologically normal, while 61 showed chronic superficial gastritis; Hp was found in 44.3% (27/61) of the patients with chronic gastritis, but in none of those with normal histological findings, The difference was statistically significant between these two groups ( P <0.01). The presence of the organism was correlated with the grade of gastric mucosal inflammation (χ 2=24.75, P<0.01 ); (2) Hp IgG and IgA antibody levels in Hp infectied group were significantly higher than those in Hp noninfected group. When the results of Hp IgG antibody detection was compared with Hp culture and/or smear findings, the consistency rate was 81.16%. The sensitivity and specificity were 88.46% and 93.33%, respectively. The results showed that Hp IgG antibody detection could be useful in diagnosis of Hp infection, screening patients prior to endoscopy and in massive epidemilogical survey.