492例有上消化道症状儿童的胃镜及幽门螺杆菌检测

Gastroscopic findings and detection of Helicobacter pylori in 492 children with epigastric symptoms.

目的：探讨有上消化道症状儿童幽门螺杆菌（Ｈｐ）感染的特点及Ｈｐ与各种上消化道病变的关系。方法：测定４９２例患儿血清Ｈｐ－免疫球蛋白（Ｉｇ）Ｇ抗体，进行电子胃镜检查并取胃窦部活检组织作细菌培养和组织病理学检查。结果：慢性胃炎的发生率为１００％。单纯慢性胃炎１７２例，伴十二指肠球炎９５例，伴十二指肠溃疡１０８例，伴滤泡样改变１１７例；４９２例中Ｈｐ呈阳性２９２例（５９．４％）。Ｈｐ阳性率随年龄增长而上升。Ｈｐ阳性组中，７７．１％Ｈｐ－ＩｇＧ抗体阳性，而阴性组仅１９．０％，两组比较差异非常显著（Ｐ＜０．０１）。Ｈｐ阳性组中粘膜炎症呈活动性占７６．１％，阴性组占８．６％；十二指肠球炎分别占８４．６％和２３．３％；十二指肠溃疡分别占９７．７％和９．１％；滤泡样改变分别占９３．１％和２０．０％。结论：①有症状儿童Ｈｐ阳性率为５９．４％，阳性率随年龄增长而上升；②胃粘膜病变越重Ｈｐ阳性率越高；③胃粘膜病变越重，Ｈｐ阳性率越高，活动性炎症发生率就越高。

bjective: To investigate the characteristics of Helicobacter pylori (Hp) infection in children with epigastric symptoms and the relationship between Hp infection and upper alimentary disease. Methods: Electronic gastroscopy and antral biopsies were performed and Hp antibodies were detected with ELISA in 492 children. Results: All children had chronic gastritis, 172 cases with simple chronic gastnitis, 95 cases with duodenitis, 108 cases with duodenal ulcer and 117 cases with follicular degeneration. The infection rate of Hp was 594%. Infection rate of Hp increased with age. There was significant difference in positive rate of Hp IgG antibody between Hp positive group and Hp negative group (771% and 190% respectively, P>001) 761% of chronic gastritis, 846% of duodenitis, 977% of duodenal ulcer and 931% of follicular degeneration in Hp positive children manifested active mucosal inflammation, while only 86%,233%,91% and 200% respectively in Hp negative children. Conclusions: 594% in symptomatic children and increased with age. The more sever lesion of mucosa, the higher positive rate of Hp and the higher rate of active mucosal inflammation.