儿童消化性溃疡临床特征与微生物菌群特征、胃镜表现的相关性分析

Correlation analysis of clinical characteristics,microbial flora characteristics and gastroscopic manifestations of peptic ulcer in children

目的探讨儿童消化性溃疡的临床特征与微生物菌群特征、胃镜表现的相关性。方法选取2019年1月至2022年12月青岛市第八人民医院收治的100例消化性溃疡患儿进行回顾性分析,依照胃镜诊断的溃疡部位将所有患儿分为胃溃疡组(n=22)、十二指肠溃疡组(n=60)、复合溃疡组(n=18),对比3组患儿临床一般情况、微生物菌群特征,分析不同溃疡部位与临床一般情况、微生物菌群特征的相关性。并将所有患儿依照是否合并幽门螺旋杆菌(Hp)感染情况进行分组,分为Hp感染组(n=41)和非Hp感染组(n=59),分析Hp感染与临床一般情况、微生物菌群特征的相关性。结果胃溃疡组、十二指肠溃疡组、复合溃疡组患儿性别、病程、溃疡最大直径及乳酸杆菌、双歧杆菌、类杆菌、大肠杆菌、粪肠球菌等肠道菌群计数比较,差异均无统计学意义(P>0.05),胃溃疡组、十二指肠溃疡组、复合溃疡组患儿年龄、Hp检测结果、淋巴滤泡形成、胃黏膜炎症活动性以及腹痛情况比较,差异均有统计学意义(P<0.05)。Spearman相关分析结果表明,不同溃疡部位与性别、病程、溃疡最大直径、肠道菌群计数无明显相关性(P>0.05),不同溃疡部位与患儿年龄、Hp检测结果、淋巴滤泡形成、胃黏膜炎症活动性以及腹痛情况呈正相关(P<0.05);Hp感染组与非Hp感染组患儿性别、年龄、病程、腹痛情况比较,差异均无统计学意义(P>0.05),Hp感染组与非Hp感染组患儿溃疡最大直径、淋巴滤泡形成、胃黏膜炎症活动性及乳酸杆菌、双歧杆菌、类杆菌、大肠杆菌、粪肠球菌等肠道菌群计数比较,差异均有统计学意义(P<0.05)。Spearman相关分析结果表明,Hp感染情况与性别、年龄、病程、腹痛情况无明显相关性(P>0.05),Hp感染情况与患儿溃疡最大直径、淋巴滤泡形成、胃黏膜炎症活动性及大肠杆菌、粪肠球菌计数呈正相关(P<0.05),与乳酸杆菌、双歧杆菌、类杆菌计数呈负相关(P<0.05)。结论不同儿童消化性溃疡的临床特征与生物菌群特征、胃镜表现具有一定关系,其中不同溃疡类型与患儿年龄、Hp检测结果、淋巴滤泡形成、胃黏膜炎症活动性以及腹痛情况具有一定关系,不同Hp感染情况与溃疡最大直径、淋巴滤泡形成、胃黏膜炎症活动性、微生物菌群计数具有一定关系。

Objective To investigate the correlation between the clinical characteristics of children's peptic ulcer and the characteristics of microbial flora and gastroscopy.Methods A total of 100 children with peptic ulcer admitted in Qingdao Eighth People's Hospital from January 2019 to December 2022 were selected as the research objects.All children were divided into gastric ulcer group(n=22),duodenal ulcer group(n=60)and compound ulcer group(n=18)according to the ulcer sites diagnosed by gastroscope.The clinical general conditions and microbial flora characteristics of the three groups of children were compared,and the correlation between different ulcer sites and clinical general conditions and microbial flora characteristics was analyzed.All children were divided into Hp infection group(n=41)and non Hp infection group(n=59)according to whether they were infected with Helicobacter pylori(Hp)or not.The correlation between Hp infection and clinical general conditions,microbial flora characteristics was analyzed.Results There was no statistically significant differences in the sex,couse of disease maximum diametor of ulcer and the number of intestinal bacteria such as Lactobacillus,Bifidobacterium,Bacteroides,Escherichia coli and Enterococcus faecalis among children in gastric ulcer group,duodenal ulcer group and compound ulcer group(P>0.05).The age,Hp detection results,lymphoid follicles formation,inflammatory activity of gastric mucosa and abdominal pain among the three group were significantly different and the differences were statistically significant(P<0.05).The spearman correlation analysis showed that there were no statistically significant correlation between different ulcer sites and gender,course of disease,maximum diameter of ulcer,intestinal flora count(P>0.05),but there were positive correlation between different ulcer sites and children's age,Hp detection results,lymphoid follicles formation,gastric mucosal inflammatory activity and abdominal pain(P<0.05);there was no statistically significant differences between Hp infected group and non Hp infected group in terms of sex,age,course of disease and abdominal pain(P>0.05).There were significant differences between Hp infected group and non Hp infected group in terms of the maximum diameter of ulcer,formation of lymphatic follicles,inflammatory activity of gastric mucosa,Lactobacillus,Bifidobacteria,Bacteroides,Escherichia coli,Enterococcus faecalis and other intestinal flora counts(P<0.05);Spearman correlation analysis showed that there were no significant correlation between Hp infection and gender,age,course of disease,abdominal pain(P>0.05).Hp infection was positively correlated with the maximum diameter of the ulcer,the formation of lymphatic follicles,the activity of gastric mucosa inflammation,the number of Escherichia coli and Enterococcus faecalis(P<0.05),and negatively correlated with the number of Lactobacillus,Bifidobacteria and Bacteroides(P<0.05).Conclusion The clinical characteristics of different children's peptic ulcer are related to the characteristics of biological flora and gastroscopic manifestations.Among them,different types of ulcer are related to children's age,Hp detection results,lymphoid follicles formation,gastric mucosal inflammatory activity and abdominal pain.Different Hp infection is related to the maximum diameter of ulcer,lymphoid follicles formation,gastric mucosal inflammatory activity and microbial flora count.