幽门螺杆菌粪便抗原检测在川崎病患儿中的应用研究  

Application of Helicobacter pylori stool antigen detection in children with Kawasaki disease

作　　者：雷小雨 贺美玲 王大利 李轶 孙玉婵 LEI Xiaoyu;HE Meiling;WANG Dali;LI Yi;SUN Yuchan(Department of Gastroenterology,Dalian Children's Hospital of Dalian Medical University,Dalian 116012,China)

机构地区：[1]大连医科大学附属大连市儿童医院消化科,辽宁大连116012

出　　处：《中国中西医结合儿科学》2018年第5期428-430,共3页Chinese Pediatrics of Integrated Traditional and Western Medicine

摘　　要：目的川崎病患儿需长期口服阿司匹林,阿司匹林长期应用对胃黏膜易造成损害。阿司匹林和幽门螺杆菌(Hp)感染又是两大最常见的胃黏膜损害因子,本研究采用Hp粪便抗原检测的方法,探讨川崎病患儿口服小剂量阿司匹林与Hp感染在胃黏膜损伤中的相互作用,为临床治疗提供参考。方法选择川崎病患儿这一特殊人群(需长期口服小剂量阿司匹林至少3个月)。选择2016年7月至2018年6月在大连市儿童医院收治的川崎病患儿101例为研究对象,根据Hp粪便抗原检测结果划分为Hp阳性组27例和Hp阴性组74例。根除治疗前进行消化道症状评分。Hp感染阳性者进行根除Hp,给予阿莫西林、克拉霉素和洛赛克联合口服根除10d。停药1个月后再次给予评分并复查Hp粪便抗原。Hp感染阳性组在根除Hp成功后再次进行消化道症状评分。结果根除治疗前Hp阳性组及Hp阴性组消化道症状评分比较差异有统计学意义(P<0.05);对Hp感染阳性患儿给予根除治疗后22例粪便抗原阴性,考虑根除治疗成功,5例根除失败。Hp阳性患儿根除治疗成功后与Hp阴性患儿比较消化道评分差异无统计学意义(P>0.05)。结论在川崎病患儿中口服阿司匹林及Hp感染在胃黏膜损伤中有协同作用,建议需要长期应用阿司匹林的患儿给予根除Hp治疗。Objective Children with Kawasaki disease need long-term oral aspirin,Long term application of aspirin can cause gastric mucosal damage.Aspirin and Helicobacter pylori infection are the two most common gastric mucosal damage factors.This study uses the method of Helicobacter pylori stool antigen test to explore interaction between children's oral small-dose aspirin and Helicobacter pylori(Helicobacter pylori,Hp)infection in children with Kawasaki disease in order to provide a reference for clinical treatment.Methods Totally 101 cases of Kawasaki disease were selected,who require long-term low-dose oral aspirin for at least 3 months,from July 2016 to June 2018.They were divided into Hp-positive group(27)and Hp-negative group(74).Before eradication treatment,the symptom scoring of digestive system was made.The Hp-positive patients received Hp eradication,who took amoxicillin,clarith romycin and omeprazole orally to eradicate Hp for 10 days.One month after stopping the medication,the scoring was made again,and Hp stool antigen was detected again.After successful Hp eradication in the Hp-positive group,the symptom scoring of digestive system was performed again.Results There was statistical difference in the symptom scores between Hp-positive group and Hp-negative group before eradication treatment(P<0.05).After the treatment,the stool antigen was negative in 22 cases in the Hp-positive children,which was considered that the eradication treatment was successful.The treatment failed in 5 cases.There was no statistical difference in the digestive score between Hp-positive children after the treatment and Hp-negative children(P>0.05).Conclusion Aspirin and Hp have a synergistic effect on gastric mucosal injury.It is suggested that children with long-term use of aspirin receive Hp-eradication treatment.

关 键 词：川崎病 幽门螺杆菌粪便抗原检测 儿童 

分 类 号：R725.4[医药卫生—儿科]