幽门螺杆菌感染与6岁以上儿童再发性腹痛的关系及其治疗

Correlation between Helicobacter Pylori Infection and Recurrent Abdominal Pain in Children Over 6 Years Old and Its Treatment

目的探讨幽门螺杆菌(Hp)感染与6岁以上儿童再发性腹痛(RAP)的关系及Hp感染的相关性治疗。方法选择2007年3月-2009年2月在本院就诊的符合RAP诊断的6岁以上患儿180例,同期选择无RAP的健康儿童30例作为健康对照组,采用14C-尿素呼气试验(14C-UBT)检测Hp感染情况;对Hp阳性的RAP患儿予根除Hp治疗,观察腹痛缓解率、Hp转阴率。结果RAP组Hp感染阳性率为58.33%,较健康对照组Hp感染率(20.00%)显著升高(P<0.01)。RAP组的3个年龄组中,12～14岁组Hp阳性率(69.35%)显著高于6～8岁组(46.51%)和9～11岁组(56.00%)(Pa<0.05)。RAP组中男、女的Hp阳性率分别为55.26%、60.58%,二者比较差异无统计学意义(P>0.05)。有无不良饮食习惯,家族中有无胃病史者Hp感染阳性率分别是45.56%、12.78%,49.44%、8.89%,二组比较差异均有统计学意义(Pa<0.01)。三联疗法根除Hp采用与否腹痛的缓解率、Hp转阴率分别为92.39%、15.38%,89.13%、7.69%,二组比较差异有统计学意义(Pa<0.01)。结论Hp感染与RAP有关,可能为RAP的主要病因。Hp感染率随年龄增长而增高,与不良饮食习惯、家族史有关。采取三联疗法根除Hp可缓解RAP患儿腹痛症状,并可使Hp感染转阴,对预防RAP反复发作亦有重要意义。

Objective To explore the correlation between Helicobacter pylori （Hp） infection and recurrent abdominal pain （RAP） in children over 6 years old and its relative treatment.Me-thods One hundred and eighty children over 6 years old with the diagnosis of RAP from Mar.2007 to Feb.2009 were selected,30 healthy children without RAP were taken as the healthy control group at the same period.14C-urea breath test （14C-UBT） was used to detect whether the patient was infected by Hp.The radical cure of Hp was given to the Hp-positive children with RAP,and the remission rate of children with RAP and the Hp negative rate were observed.Results The positive rate in RAP group was 58.33%,which was higher significantly than that in healthy control group（20.00%）（P0.01）.Among the 3 different age groups in RAP,Hp positive rate in 12-14 year-old group （69.35%） was significantly higher than that in 6-8 year-old group （46.51%） and 9-11 year-old group （56.00%） （Pa0.05）.The positive rate between male and female was 55.26% and 60.58%,and there was no significant difference （P0.05）.The positive rate of those with and without bad eating habits were 45.56% and 12.78%,and the positive rate of with and without family gastrosis history was 49.44% and 8.89%,which both had significant difference between them（Pa0.01）.The remission rate and Hp negative rate of whether the use of triple Hp therapy for the eradication of abdominal pain were 92.39%,15.38%,89.13% and 7.69%,and there were significant differences between the 2 groups （Pa0.01）.Conclusions There is a close relation between Hp infection and RAP,so Hp infection may be the main cause of RAP.The proportion of Hp infection is increased with the growth of ages and is related with bad eating habits and the family gastrosis history.The use of triple Hp eradication therapy can relief the symptoms of abdominal pain RAP in children,and can change Hp infection into negative and thus has significant effect on the prevention of recurrent RAP in children.