深圳市宝安地区3～6岁幼儿幽门螺旋杆菌感染现状的调查与对策

目的:调查深圳市宝安区3～6岁儿童幽门螺旋杆菌(Hp)感染现状并研究相关对策。方法:以深圳市宝安区300例3～6岁在园儿童为调查研究对象,其中男155例,女145例,3～4岁、～5岁、～6岁各100例,采用胶体金法检测血清Hp-lgG抗体及粪便HP抗原,对两项均阳性可确定Hp感染者随机分成治疗组(A组)及对照组(B组),A组采用奥美拉唑+克拉霉素+羟氨苄青霉素治疗,B组采用胶体次枸橼酸铋+灭滴灵+羟氨苄青霉素治疗,14天及4～8周后比较分析结果。结果:血清Hp-lgG抗体及粪便Hp抗原均阳性24例(8%)。其中,3～4岁5例,～5岁8例,～6岁11例,300例受调查儿童中,血清Hp-lgG抗体阳性51例,粪便Hp抗原阳性30例,治疗组较对照组在按时坚持服药、根除Hp感染、防止Hp感染复发方面与对照组比较差异有统计学意义,在不良反应和因不良反应停药方面与对照组比较差异无统计学意义。结论:深圳市宝安区儿童Hp感染水平较国内报导的低,但随年龄增长,感染有增加趋势,并与家庭成员健康状况、饮食卫生、生活习惯等关系密切。含质子泵抑制剂奥美拉唑和大环内酯类克拉霉素的治疗方案较含铋剂的治疗方案在服药依从性、根除Hp及防止复发方面具有明显优势,可作为治疗Hp感染的一线选择。

Objective ：To investigate the status of helicobacter pylori infection and study the relating ts in children in Bao＇an District of Shenzhen. Methods：300 children aged 3 -6 years old from kindergarten in Bao＇an district were studied, among them there are 155 boys and 145 girls and 100 cases from 3 -4 years old, -5 years old, 6years old for each. Hp - IgG antibody in serum and Hp antigen in feces were detected by colloidal gold technique. Those both posi-tire with Hp -IgG antibody in serum and Hp antigen in feces and ensured to be infected by Hp were divided into treating group （ group A ） and control group （ group B ） randomly. Omeprazole ＋ Clarithromycin ＋ Amoxicillin were used in group A and Colloidal bismuth subcitrate ＋ Metronidazole ＋ Amoxicillin were used in group B. The results were compared and analyzed after 14 days and 4 - 8 weeks later. Results： There are 24 cases（8% ） both positive with Hp - IgG antibody in serum and Hp antigen in feces and there are 5 cases between 3 - 4 years old,8 cases - 5 years old,and 11 cases -6 years old among them. There are 51 cases positive with Hp -IgG antibody in serum and 30 eases positive with Hp antigen in feces. There is statistical significance in taking drus operability, eradicating Hp infection and preventing Hp infection recurrence between the treating group and the control group. There is no statistical significance in adverse reaction and drug discontinence because of the adverse reaction be- tween these two groups. Conclusion：The infective level of Hp among children in Baohn district of Shenzhen city is lower than that reported in China, but the infection ratio in- creases with age and is closely related to the health status of family members, dietary hy- giene and the living habits. There is clear advantage in the therapy project including proton pump inhibitors （ PPIs ） Omeprazole, macrolides Clarithromycin over drugs taking operability, eradicating Hp and preventing Hp infection recurrence. This project can be the first - line choice on treating Hp infection.