儿童幽门螺杆菌感染相关性胃炎的临床特点和防治策略

Clinical features and management strategy for helicobacter pylori-related gastritis in childhood

目的 探讨儿童幽门螺杆菌 (Hp)感染相关性胃炎的临床特点和防治策略。 方法 采用日本产GIF -N30型纤维胃镜对 40 2例 7个月～ 14岁儿童进行胃镜检查并取胃窦部粘膜组织行病理检查及Hp检测。 结果 检出Hp感染相关性胃炎 137例 ,检出率为 34 0 8% ,其中男 78例 ,女 5 9例 ,Hp感染率男女性别间无差异(P >0 0 5 ) ,但各年龄组之间差异显著 (P <0 0 5 )。临床可表现为恶心、呕吐、腹痛、消化道出血、食欲不振、消瘦、头痛、头昏等。胃镜下胃窦粘膜微小结节改变及病理显示固有层内有淋巴滤泡形成者 ,Hp检出率较高 (>5 0 % )。结论 儿童Hp感染随年龄增长而增多 ,但与性别无关。Hp感染相关性胃炎临床表现无特异性 ,诊断有赖于胃镜。

Objective To discuss clinical features and management strategy for Helicobacter pylori(HP)-related gastritis in childhood.Methods With fiber gastroscope type GIF-N30 (Japan),we had done fiberoptic gastroscopy and mucosal biopsies in the gastric sinus for pathological examination and HP detection on 402 children aging from 7 months to 14 years.Results HP-related gastritis was diagnosed in 137 children with a rate of 34 08%.78 cases were male and 59 cases were female with no statistical difference in HP infection rate.There were,however,significant differences between age groups.The clinical manifestations included nausea,vomiting,abdominal pain,abdominal distention,gastrointestinal bleeding,poor appetite,marasmus,headache,dizziness and etc.More than 50% of the children were positive for HP in those who had mucosal micronodular changes in the sinuses under gastroscopy and lymph follicule formation in lamina propria.Conclusion HP infection in childhood increases with aging,but it is not associated with sex.The diagnosis of HP-related gastritis should be based on fiberoptic gastroscopy,pathological examination and HP detection because of the lacking in specificity of its manifestations.