幽门螺杆菌感染儿童家庭内聚集及根除治疗相关性探讨

Relationship between family aggregation and eradication therapy for Helicobacter pylori infection in children.

目的 研究幽门螺杆菌(H.pylori)感染儿童家庭内聚集现象,探讨根除H.pylori感染的相关性治疗。方法 经胃镜检查、病理切片、快速尿素酶试验(RUT)、PCR-UreA-DNA确诊H.pylori感染患儿226例,对其383位父母及部分家庭成员进行流行病学调查。应用洛赛克+克拉霉素+羟氨苄青霉素三联1周疗法,治疗92例患儿,分成与感染的父母同治组和未同治组,观察对照2组H.pylori根除率差异性。结果 226个家庭383位父母及部分家庭成员中H.pylori总阳性检出率为33.8％。41例患儿菌株血清基因型与73位父母基因型符合率为89％(65/73)。与父母同治组H.pylori根除率为95.2％(40/42);未同治组H.pylori根除率为80％(40/50),x^2=4.67,P<0.05,二组间差异有显著性意义。结论 H.pylori感染有突出的家庭内聚集现象,父母及有密切接触的其他家庭成员是儿童感染的重要传染源;与感染父母或家庭成员的同步治疗,对提高患儿H.pylori根除率与预防再感染有重要意义。

Objective To study the phenomenon of the family aggregation H. pylori infection in children, and to make research on the eradication therapy. Methods H. pylori infection was confirmed by the examination of en-doscopy,Giemsa staining of histology,RUT,PCR-UreA-DNA in 226 children. Serological tests and 13C-urea breath tests (13C-UBT) were carried out among their 383 parents and family members. 92 children with H. pylori infection, divided into two groups(in group 1,only children were treated and in group 2,both children and their parents were treated), were treated with three antibiotics(Losec,Clarithromycin and Amoxicillin)for a week. Results The general positive rate of H. pylori infection was 83.8% among 383 members of 226 families. Among 73 parents of 41 children with H. pylori infection, the genotypes of 65 parents were in correspondence with thase of their children. The corresponding rate is 89% (65/73).The eradication rate of group 1 and group 2 were 95.2% (40/42) and 80%(40/50)(x2 = 4.67, P <0.05), respectively. The difference was significant. Conclusion There is a remarkable phenomenon of family aggregation in H. pylori infection. The principal source of H. pylori infection to children is from their parents and closely contacted family members. Treatment of parents and family members is also important for eradication therapy for children.