贵阳地区儿童时期幽门螺杆菌感染后胃镜检查和病理组织学特点及疗效研究  

Gastroscopic and Pathological Characteristics of Helicobacter Pylori Infection in Childhood and the Treatment Effect Analysis in Guiyang

作　　者：龙梅 朱莉 包林林 潘佩英 LONG Mei;ZHU Li;BAO Linlin;PAN Peiying(Department of Gastroenterology,Guiyang Maternal and Child Health Hospital,Guiyang Children's Hospital,Guiyang550003,China)

机构地区：[1]贵州省贵阳市妇幼保健院,贵阳市儿童医院消化科,550003

出　　处：《中国全科医学》2020年第36期4562-4566,共5页Chinese General Practice

基　　金：贵州省科学技术厅基金项目(黔科合SY字〔2012〕3131)。

摘　　要：背景随着儿童胃镜检查的普及,研究发现儿童时期幽门螺杆菌(H.pylori)感染与胃肠疾病的发生有密切关系,但针对儿童时期H.pylori感染后胃镜检查及病理组织学检查的研究相对较少。目的探讨贵阳地区儿童时期H.pylori感染后胃镜检查、胃黏膜组织病理学特点及疗效。方法随机选择贵阳市妇幼保健院/儿童医院消化科2016年6月—2018年9月收治的因腹痛、呕吐、消化道出血等症状入院的210例患儿为研究对象。依据H.pylori检测结果,H.pylori阳性者为阳性组,H.pylori阴性者为对照组,分析儿童时期H.pylori感染后胃镜检查、胃黏膜病理组织学特点及疗效。结果210例患儿中阳性组104例、对照组106例,儿童时期H.pylori感染率为49.5%。H.pylori感染平均发病年龄为(7.2±1.3)岁。阳性组胃镜检查提示糜烂出血性胃炎58例、消化性溃疡23例、结节性胃炎13例、消化性溃疡伴结节性胃炎10例,对照组胃镜检查提示糜烂出血性胃炎84例、消化性溃疡18例、结节性胃炎3例、消化性溃疡伴结节性胃炎1例。阳性组糜烂出血性胃炎发生率低于对照组,结节性胃炎以及消化性溃疡伴结节性胃炎的发生率高于对照组(P<0.05),轻度炎症发生率低于对照组,重度炎症发生率高于对照组(P<0.05);阳性组淋巴细胞阳性发生率高于对照组(P<0.05)。阳性组给予标准三联疗法抗H.pylori治疗后,复查13C尿素呼气试验阴性93例、阳性11例。结论贵阳地区儿童时期H.pylori感染率为49.5%,以学龄期儿童发病为主;H.pylori感染后胃镜检查以糜烂出血性胃炎、消化性溃疡、结节性胃炎为主要表现,糜烂出血性胃炎发生率明显降低,结节性胃炎以及消化性溃疡伴结节性胃炎的发生率明显升高,胃黏膜病理组织学检查结果以重度炎症为主,重度炎症改变及淋巴细胞浸润程度与H.pylori感染相关,标准三联疗法对H.pylori根除率为89.4%。Background With the popularization of gastroscopy in children,studies have found that Helicobacter pylori(H.pylori) infection in childhood is closely related to the occurrence of gastrointestinal diseases.However,the studies regarding the gastroscopy and pathological examination are relatively few.Objective To investigate the gastroscopic and pathological characteristics of H.pylori infection in childhood and analyze the treatment effect in Guiyang.Methods A total of 210 children with symptoms such as abdominal pain,vomiting,and gastrointestinal bleeding who were admitted to the Department of Gastroenterology,Guiyang Maternal and Child Health Hospital/Guiyang Children’s Hospital were randomly selected as the research objects from June 2016 to September 2018.After the H.pylori detection,children with positive results were assigned to the positive group,and those with negative results were to the control group.The gastroscopic and pathological characteristics of H.pylori infection were collected and the treatment effect was analyzed.Results Among the 210 children,104 children were in the positive group and 106 children were in the control group.The infection rate was 49.5%,and the average onset age of H.pylori infection was(7.2±1.3).Gastroscopy in the positive group revealed 58 cases of erosive hemorrhagic gastritis,23 cases of peptic ulcers,13 cases of nodular gastritis,and 10 cases of peptic ulcer with nodular gastritis.Gastroscopy in the control group revealed 84 cases of erosive hemorrhagic gastritis,18 cases of peptic ulcer,three cases of nodular gastritis,and one case of peptic ulcer with nodular gastritis.The incidence of erosive hemorrhagic gastritis in the positive group was significantly lower than that in the control group,incidence of nodular gastritis,and peptic ulcer with nodular gastritis was significantly higher in the positive group than that in the control group(P<0.05).The incidence of mild inflammation in the positive group was lower than that in the control group,and the incidence of severe

关 键 词：儿童 幽门螺杆菌 胃镜检查 病理学 胃黏膜 根除率 

分 类 号：R377[医药卫生—病原生物学]