幽门螺杆菌阳性消化性溃疡患儿治疗效果的影响因素分析  

Influencing factors for curative effect on children with Helicobacter pylori-positive peptic ulcer

作　　者：何兰芬 彭罕鸣 陈静 易静 詹春梅 李恒[2] HE Lan-feng, PENG Han-ming, CHEN Jing, YI Jing, ZHAN Chun-mei, LI Heng(Wuhan Children＇s Hospital, Wuhan , Hubei 430000, Chin)

机构地区：[1]武汉儿童医院消化内科二病区,湖北武汉430000 [2]武汉大学中南医院妇科肿瘤病区,湖北武汉430000

出　　处：《中华医院感染学杂志》2018年第6期933-935,942,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨幽门螺杆菌阳性消化性溃疡患儿病原菌根除效果的影响因素,为临床提供参考。方法选取2015年5月-2017年3月临床收治的幽门螺杆菌阳性消化性溃疡患儿88例为研究对象,给予患儿抗幽门螺杆菌治疗,对患儿治疗后的病原菌根除率进行统计,分析影响病原菌根除效果的相关因素,并比较患儿治疗前后的炎症因子和症状评分。结果 88例患儿经治疗后,66例患儿根除成功,根除率为75.00%;经Logistic回归方程证实年龄、营养不良、先天性疾病、低蛋白血症、治疗依从性、阿莫西林耐药、克拉霉素耐药和基因多态性是影响幽门螺杆菌阳性消化性溃疡患儿病原菌根除效果的相关因素;治疗后患儿的TNF-α、IL-6、IL-8、IL-12和IL-18等炎症因子指标较治疗前均降低,差异有统计学意义;治疗后患儿的上腹疼、腹胀、嗳气、反酸等临床症状评分较治疗前降低,且差异有统计学意义。结论给予患儿奥美拉唑、阿莫西林、克拉霉素、胶体果胶铋治疗后可一定程度地根除幽门螺杆菌,改善患儿炎症因子指标和临床症状。OBJECTIVE To explore the influencing factors for eradication of pathogens in children with Helicobacter pylori-positive peptic ulcer so as to provide guidance for clinical treatment.METHODS A total of 88 children with H.pylori-positive peptic ulcer who were treated in hospitals from May 2015 to Mar 2017 were recruited as the study objects and received the anti-H.pylori therapy,the eradication rate of pathogens was statistically analyzed after the treatment,the influencing factors for eradication of pathogens were observed,and the levels of inflammatory factors and scores of symptoms were compared before and after the treatment.RESULTS Pathogens were eradicated successfully in 66 of 88 children,with the eradication rate 75.00%.Logistic regression equation showed that the influencing factors for the eradication of pathogens in the children with H.pylori-positive peptic ulcer included age,malnutrition,congenital disease,hypoproteinemia,treatment compliance,amoxicillin resistance,clarithromycin resistance and genetic polymorphisms.The levels of inflammatory factors such as TNF-α,IL-6,IL-8,IL-12 and IL-18 were lower after the treatment than before the treatment,and there were significant differences.The scores of clinical symptoms such as upper abdominal pain,abdominal distension,belching and acid reflux were lower after the treatment than before the treatment,and there were significant differences.CONCLUSION Omeprazole,amoxicillin,clarithromycin and colloidal pectin bismuth may eradicate H.pylori strains to some extent and improve the inflammatory factors as well as the clinical symptoms.

关 键 词：幽门螺杆菌阳性 消化性溃疡 根除效果 相关因素 

分 类 号：R573.1[医药卫生—消化系统]