小儿幽门螺杆菌感染与慢性胃炎

Helicobacter pylori infection and chronic gastritis in children

目的 :研究幽门螺杆菌 (Helicobacterpylori,Hp)感染与小儿不同类型慢性胃炎之间的关系。 方法 :对我院 2 0 0 0年—2 0 0 2年 14 0 4例具有上消化道症状 ,经胃镜检查确诊为慢性胃炎的患儿进行胃黏膜活检 ,分别行病理组织学检查及快速尿素酶试验、改良Giemsa染色找Hp ,同时患儿行血清抗HpIgG检测和 (或 ) 13 碳 尿素呼气试验 (13 C UBT)和 (或 )粪幽门螺杆菌抗原检测 (Helicobacterpyloristoolantigen ,HpSA)。 结果 :14 0 4例慢性胃炎患儿中 ,Hp感染率为 4 5 .3%。各种不同类型慢性胃炎中 ,以胃镜下结节性胃炎和消化性溃疡伴慢性胃炎的患儿Hp感染率为最高 ,分别为 71.2 %和 6 8.0 % ,明显高于其他胃炎组 (P <0 .0 1)。胃黏膜病理组织学改变 ,Hp感染组引起的黏膜炎症程度较重 ,淋巴滤泡形成比例明显较对照组高 (P <0 .0 1)。结论 :小儿时期Hp感染率已较高 ,随年龄增长Hp感染率增高。并且与小儿胃十二指肠疾病关系密切 ,其中与胃镜下结节性胃炎和消化性溃疡伴慢性胃炎最为密切。胃黏膜组织炎症程度越重 ,Hp感染阳性率越高。

Objective: To study the relationship between Helicobacter pylori (Hp) infection and chronic gastritis in children. Methods:1 404 cases aged 1 to 14 years old between 2000 and 2002 were studied. All patients were diagnosed to have chronic gastritis by gastroscopy. In these patients, biopsies were taken for pathologic examination and Hp were detected by urease test, Giemsa staining, serologic examination and /or 13 C-UBT and/or HpSA were done at the same time.Results:Of the 1 404 children, 636 (45.3%) were Hp positive. Hp was detected in 71.2% of 233 patients with nodular gastritis, 68.0% of 156 patients with peptic ulcers. These positive rates were statistically higher than that in patients of other types chronic gastritis (P<0.01). Mucosa inflammation were more severe and lymphoid follicles were more frequently found in Hp infection group compared with Hp negative group (P<0.01). Conclusions:The Hp positive rate is 45.3% in children with chronic gastritis and increases with age. Chronic gastritis, particularly nodular gastritis and peptic ulcers in children are closely associated with Hp infection. The more severe the gastric mucosa lesions, the higher positive rates of Hp.