儿童功能性消化不良140例临床分析

Clinical analysis of 140 children with functional dyspepsia

目的探讨琼海市儿童功能性消化不良(Functional Dyspepsia,FD)与胃肠激素之间的关系,为本市儿童FD的防治提供科学依据。方法选取2017年3月至2019年3月在琼海市中医院就诊的140例6~13岁儿童,年龄(9.1±2.3)岁,根据年龄将病儿分为≤9岁组和>9岁组,其中男86例,女54例,采用罗马Ⅳ标准进行FD诊断,比较两组病儿FD的常见临床表现;幽门螺旋杆菌(Helicobacter Pylori,Hp)感染检查采用13C呼气试验,采用ELISA法检测病儿血浆中的瘦素、生长素及酪酪肽水平,并分析这三种胃肠激素与FD病儿Hp感染之间的关系;采用SPSS 22.0统计软件进行分析。结果研究发现,140例病儿中上腹痛的发生率最高(93.57%),其次为恶心和(或)呕吐(74.29%)、早饱(55%)和腹胀(31.43%)。≤9岁组与>9岁组相比,腹痛、恶心和(或)呕吐差异无统计学意义(P>0.05);早饱、腹胀差异有统计学意义(P<0.05)。不同组间儿童Hp阳性率比较差异无统计学意义(P>0.05)。两组病儿血浆中瘦素水平比较,Hp阳性组病儿血浆中瘦素水平(2435.32±256.13)ng/L显著高于Hp阴性组(1898.45±304.88)ng/L;两组病儿血浆中生长素水平比较,Hp阳性组病儿血浆中生长素水平(212.06±19.81)ng/L显著低于Hp阴性组(296.27±26.57)ng/L;两组病儿血浆中酪酪肽水平比较Hp阳性组病儿血浆中酪酪肽水平与Hp阴性组相比差异无统计学意义(P>0.05)。结论瘦素、生长素及酪酪肽这三种胃肠激素参与了儿童FD的发病机制,可能会成为儿童FD临床治疗的新靶点。

Objective To explore the relationship between functional dyspepsia(FD)and gastrointestinal hormones in children in Qionghai city,and to provide scientific evidence for prevention and treatment of FD in children in this city.MethodsA total of140 children aged 6-13 years old who were admitted to the Qionghai Hospital of Traditional Chinese Medicine from March 2017 to March 2019 were selected,with the age of(9.1±2.3)years old.The children were divided into≤9 years old group and>9 years old group according to age,including 86 males and 54 females.The FD diagnosis was performed using the Rome III criteria.The common clinical manifestations of FD in the two groups were compared.The Helicobacter pylori(Hp)infection was tested by13 C breath test and detected by ELISA.The plasma levels of leptin,ghrelin and PYY were analyzed,and the relationship between these three gut hormones and Hp infection in children with FD was analyzed.SPSS 22.0 statistical software was used for analysis.ResultsThe study found that the incidence of upper abdominal pain was highest in 140 patients(93.57%),followed by nausea and/or vomiting(74.29%),early satiety(55%)and bloating(31.43%).There was no significant difference in abdominal pain,nausea and/or vomiting between the 9-year-old group and the>9-year-old group(P>0.05).The difference of early satiety and abdominal distension was statistically significant(P<0.05).There was no significant difference in Hp positive rate between children in different groups(P>0.05).The plasma leptin level in HP positive group(2435.32±256.13)ng/L was significantly higher than that in HP negative group(1898.45±304.88)ng/L;ghrelin auxin level in HP positive group(212.06±19.81)ng/L was significantly lower than that in HP negative group(296.27±26.57)ng/L.There was no significant difference in the plasma PYY level between the two groups in the Hp positive group and the Hp negative group(P>0.05).ConclusionLeptin,ghrelin and PYY are involved in the pathogenesis of childhood FD and may become a new target for clinical treatment of children with FD.