1442例儿童幽门螺杆菌感染状况及相关性疾病分析

Analysis on Helicobacter pylori infection and its related diseases in 1 442 children in Tianjin city

目的 了解天津市儿童幽门螺杆菌 (Hp)感染状态 ,探讨儿童Hp感染状况与相关性疾病的关系。方法 采用ELISA方法对 144 2例儿童进行血清抗Hp -IgG检测 ,对其中有消化道症状的 916例行胃镜检查 ,同时取胃窦粘膜 3块分别作病理组织学检查及快速尿素酶、改良Giemsa染色找Hp菌 ,取胃液检测Hp -PCR。 4种方法中两项或两项以上阳性者诊断为Hp感染。 结果 ①144 2例中血清抗Hp -IgG阳性 6 5 1例 ,总阳性率45 .15 % ,<1岁、～ 3岁、～ 6岁、～ 10岁、～ 14岁抗Hp -IgG阳性率分别为11.19%、19.2 3%、44 .2 1%、5 4.2 0 %、6 1.46 % ;②无症状组抗Hp -IgG阳性率 31.18% (16 4/ 5 2 6 ) ;有症状组 5 3.17% (487/ 916 ) ,后者明显高于前者 (P <0 .0 0 5 ) ;③十二指肠球部溃疡 (DU)Hp感染率为90 .76 % ,高于其他胃肠道疾病 ;④病理组织学检查显示轻度浅表性胃炎和中重度浅表性胃炎Hp感染率分别为 33.2 0 %和 83.97%。结论 天津地区儿童Hp感染率较高 ,且随年龄增加而递增。有症状组Hp感染率高于无症状组。儿童胃十二指肠疾病与Hp感染密切相关 ,尤以DU与Hp感染关系更为密切。

Objective The aim of this study was to investigate the prevalence of Helicobacter pylori (Hp) infection in children in Tianjin and to study the relationship between the Hp infection and its related diseases. Methods ①Serologic examination for Hp-IgG;②Rapid urease test for Hp(Hp-Rut);③Giemsa staining for Hp;④Gastric fluid examination for Hp by PCR. Hp infection were diagnosed by at least two criteria. Results ①Of the 1 442 children, 651 were Hp-IgG positive. The total positive rate was 45.15%,Positive rates of Hp-IgG among children under the age of 1 year, 3 years,6 years,10 years and to 14 years were 11.19%,19.23%,44.21%,54.20% and 61.46%,respectively.②Positive rates of Hp-IgG were 31.18%(164/526) and 53.17%(48/916) in asymptomatie children and in patients with gastrointestinal symptoms. The rate was significantly higher in the later group ( P <0.005). ③Hp infection rate in patients with duodenal ulcer (DU) was 90.76 %,higher than that in other gastrointestinal diseases.④Histological examination showed that Hp infection rates were 33.20 % and 83.97 % in mild and moderate or severe gastritis, respectively. Conclusions ①The prevalence of Hp infection in children in Tianjin was high. ②Rate of Hp infection increased with age and Hp infection rate was higer in children with gastointestinal symptoms than with asymptomatie.③There was a high correlation in childer with gastroduodenal diseases and Hp infection especially with DU.④Hp positive rate correlated with the pathohistologic severity of gastritis.