120例再发性腹痛患儿与幽门螺杆菌感染及治疗

Helicobacter pylori infection and its treatment in 120 children with recurrent abdominal pain

对我院近6年来诊治的120例再发性腹痛患儿(RAP)进行分析,作纤维胃镜检查80例(占66.7％),其中慢性胃炎(CG)50例,十二指肠溃疡(PU)14例,两者发病率高。70例作胃粘膜快速脲素酶检测(HPUT),阳性38例(占受检病例的54.3％)。90例作血清HP-IgG检测,阳性77例(占85.6％)。表明HP感染是PU及CG的主要原因,也是致小儿RAP的重要病因。另选择HP-IgG阳性的学龄儿童55例,随机分为治疗组及对照组,治疗组加用思密达,疗程4周～6周。于治疗后1月及3月分别测定HP-IgG。结果治疗组与对照组HP清除率无差异性,但治疗组HP感染根除率71.4％,对照组为30％,有显著性差异(P<0.01)。说明思密达与对HP敏感的黄连素和甲硝唑联用,可提高HP感染的根除率。

120 children with recurrent abdominal pain (RAP) were diagnosed and treated in this hospital nearly latest 6 years. In 80 cases of them (66. 7% of the total),the fibrogastrocopic examination was adopted and its results showed that chronic gastritis (CG) could be seen in 50 cases and peptic ulcer (PU) in 14 cases, demonstrating that there was a high incidence of CG and PU in children with RAP. In addition, the rapid urease test in gastric mucosa for the detection of helicobac-ter pylori (HP) was also determined in 70 cases and 38 cases showed that positive (54. 3% of the individuals examined). Simultaneously, serum HP-IgG assay was detected in 90 cases of them, 77 cases showed positive (85. 6%). All these data indicated that the existence of HP might be the principal factor resulting in CG, PU and HP infection, the main pathogenic origin for RAP in children. Subsequently, 55 pre-school children with positive HP-IgG have been selected to observe the present treatment condition. All these subjects were into two groups: treatment group (routine treatment plus Smecta preparation) and control group (routine treatment). The treating course was designed to last for 4-6 weeks. Through the observation in 1 month and 3 months after treatment, the results showed that there was no significant difference between treatment group and control group in the elimination rate of HP infection, but significant difference between these two groups in radical cure rate (71. 4% and 30% separately, P<0. 01). It possibly indicates that the combined use of Smecta preparation with the drugs sensitive to HP infection such as berberin and metronidazone, might apparently increase the radical cure rate of HP infection.