3352例儿童经胃镜检查幽门螺杆菌感染分析

Analysis of 3 352 children infected with Helicobacter pylori by gastroscopy

目的调查我国北方地区经胃镜检查儿童的幽门螺杆菌(Helicobacter pylori, Hp)感染情况。方法选择2008年1月至2017年12月首都儿科研究所附属儿童医院行胃镜检查的患儿3 352例,进行胃窦黏膜标本快速Hp尿素酶试验。结果 10年间3 352例患儿总Hp感染率为13.4%,其中男1 881例,Hp感染检出率为14.5%(272/1 881),女1 471例,Hp感染检出率为12.1%(178/1 471),性别间比较差异无统计学意义(χ^2=3.95, P> 0.05)。2008年1月至2012年12月检测633例,Hp感染检出率为16.3%(103/633),2013年1月至2017年12月检测2 719例,Hp感染检出率为12.8%(347/2 719),差异有统计学意义(χ^2=4.076, P <0.05)。0~6岁1 004例,Hp感染检出率为7.6%(76/1 004);6~9岁896例,Hp感染检出率为14.6%(131/896);9~12岁863例,Hp感染检出率为16.9%(146/863);>12岁589例,Hp感染检出率为16.5%(97/589),4组间Hp感染检出率比较,差异有统计学意义(χ^2=44.47, P <0.01)。比较消化道出血、上消化道症状及不明原因的脐周痛Hp感染检出率,差异无统计学意义(χ^2=3.35, P> 0.05)。十二指肠溃疡Hp感染检出率高达31.95%,高于慢性浅表性胃炎的12.8%,差异有统计学意义(χ^2=46.3, P <0.01)。结论我国北方地区经胃镜检查儿童Hp感染率为13.4%,6岁后Hp阳性率明显升高,Hp感染与十二指肠溃疡密切相关。

Objective To investigate Helicobacter pylori(Hp) infection in children who underwent gastroscopy in Northern China. Methods From January 2008 to December 2017, pediatric patients with gastrointestinal symptoms who underwent endoscopy and Hp rapid urease test of gastric mucosa specimens were collected. Results There were 3 352 patients who underwent gastroscopy during the 10 years including 1 881 cases of male and 1 471 cases of female. The rate of Hp infection was 14.5%(272/1 881) and 12.1%(178/1 471) in male and female, respectively. There was no significant difference between different genders(χ^2= 3.95, P>0.05). From January 2008 to December 2012, 633 patients were tested and the rate of Hp infection was 16.3%(103/633).From January 2013 to December 2017, 2 719 patients were tested and the rate of Hp infection was 12.8%(347/2 719). The difference was significant between the two groups(χ^2= 4.076, P<0.05). The rate of Hp infection were 7.6%(76/1 004), 14.6%(131/896), 16.9%(146/863), 16.5%(97/589) in 0~6 years group, 6~9 years group, 9~12 years group, and >12 years group, respectively. There was significant difference among the four different age groups(χ^2= 44.47, P<0.01).The rate of Hp infection in duodenal ulcer(32.0%) was higher than that in chronic superficial gastritis(12.8%). There was significant difference between the two groups(χ^2= 46.3, P<0.01). Conclusions The rate of Hp infection in children examined by gastroscopy in Northern China is 13.4%. The rate of Hp infection is increasing with the age after the age of 6 years. Hp infection may play a role in the duodenal ulcer.