儿童胃炎与幽门螺杆菌感染

Helicobacter pylori infection and gastritis in children

目的 研究儿童胃炎的病理变化及其与幽门螺杆菌感染的关系。方法 对我科１９９６ 年至１９９８年间１００ 例３ 至１５ 岁儿童胃镜活检组织进行组织学观察，按１９９６ 年的Ｓｙｄｎｅｙ 胃炎标准对病变分级，分析和探讨儿童慢性胃炎的病理特点。结果 ４９ ％ 的儿童胃炎与幽门螺杆菌感染有关，而且炎症的程度和幽门腺萎缩明显高于无幽门螺杆菌感染的病例。结论 儿童幽门螺杆菌性胃炎的胃粘膜病理变化比非感染者严重，常常表现为淋巴滤泡形成及中性白细胞浸润；本组儿童幽门螺杆菌的阳性率为４９ ％ ，属于幽门螺杆菌的高感染人群。由于幽门螺杆菌感染与胃溃疡及胃癌等疾病发生关系密切，因此对幽门螺杆菌的防治应从儿童抓起。

Objective To investigate the histopathology of children gastritis, and whether the gastritis in child ren is related to Hericobacter pylori (Hp). Method 100 consecutive gastroscopic biopsies of children (from 3 to 15 years old) were observed from 1996 to 1998 in Ruijin hospital under light microscopy and evaluated by criteria of Sydney System: the degree of activity of gastritis, extent of Hp colonization, presence or absence of antral atrophy, intestinal metaplasia, and lymphoid follicles.Results 49% of children gastritis were associated with Hp infection, the severity of inflammation, degree of activity of gastritis, presence of antral atrophy, intestinal metaplasia and lymphoid follicles differed significantly (chi square test: P <0.01) between those with and without Hp. With Hp infection, there were more frequent antral atrophy, more severe inflammation, and presence of lymphoid follicles( P <0.01).Conclusion The Hp positive rate in children of this study was 49%, children with positive Hp infection had more severe gastritis than those without, and because of the close association between Hp and gastric cancer and gastric ulcer, preventive treatment of Hp should be undertaken in as early as possible. (Shanghai Med J, 2000,23∶70 72)