合并幽门螺杆菌感染对儿童原发性胆汁反流性胃炎病情的影响  

Effect of complicated Helicobacter pylori infection on disease developement in children with primary bile reflux gastritis

作　　者：蒋丰智[1] 黎小秀[1] 廖琼 张勇[1] JIANG Fengzhi;LI Xiaoxiu;LIAO Qiong;ZHANG Yong(Paediatrics Department,Dongguan Maternal and Child Health Care Hospital,Dongguan,Guangdong,52300)

机构地区：[1]广东省东莞市妇幼保健院儿科,广东东莞523000

出　　处：《实用临床医药杂志》2018年第15期113-115,共3页Journal of Clinical Medicine in Practice

摘　　要：目的探讨儿童胆汁反流性胃炎(BRG)合并幽门螺杆菌(Hp)感染对病情的影响。方法 151例原发性BRG患儿根据13C尿素呼气试验(UBT)、胃窦黏膜组织Hp快速尿素酶试验(RUT)和病理组织学检查结果分Hp阳性组和Hp阴性组。比较2组临床症状分度、胃镜下胆汁反流分级、活检组织病理学表现及分级Dixon评分。结果 Hp阳性组与Hp阴性组在发病年龄和性别方面比较无显著差异。Hp阳性组就诊时临床症状总体上较Hp阴性组重,以中度以上表现为多见。Hp阳性组胃镜下胆汁反流程度重于Hp阴性组,且与临床症状呈正相关;2组胃黏膜炎症活动性、淋巴滤泡增生、胃小凹增生、黏膜浅层血管扩张方面比较有显著差异,而在炎症程度、间质水肿、固有膜内平滑肌纤维增生、肠化生、腺体萎缩等方面则无显著差异。结论 BRG患儿合并Hp感染时临床症状、胃镜下及组织学表现更重,且胆汁反流程度加重,二者在发病中有协同关系。Objective To investigate the effect of bile reflux gastritis（ BRG） in combination with Helicobacter pylori（ Hp） infection on disease developement in children. Methods According to13 C urea breath test（ UBT）,H. pylori rapid urease test（ RUT） and histopathological examination,a totla of 151 children diagnosed with primary BRG in our hospital were divided into two groups： Hp positive group and Hp negative group. Clinical symptoms degrees,bile reflux degree under gastroscopy,biopsy histopathology and its Dixon score between groups were compared. Results There was no significant difference in age or gender between two groups. Clinical symptoms,and BRG degree in Hp positive group were more serious than that in Hp negative group,and moderate symptoms accounted for the most. BRG severity was positively related to clinical symptoms. Gastric mucosal inflammation activity,follicular hyperplasia,gastric mucosa,foveolar hyperplasia of shallow vascular dilation showed significant differences between two groups,but the inflammatory severity,interstitial edema,smooth muscle fiber hyperplasia in lamina propria,intestinal metaplasia and glandular atrophy had no significant difference between two groups. Conclusion Children with BRG in combination with Hp infection have severe clinical symptoms,gastroscopy and histological manifestations,and aggravated bile reflux. So there is a synergistic enhancement effect between them.

关 键 词：胃炎 胆汁反流性胃炎 幽门螺杆菌 临床特征 组织病理学 

分 类 号：R573.3[医药卫生—消化系统]