无锡地区儿童原发性十二指肠胃反流对幽门螺杆菌感染及耐药性的影响  

Effects of primary duodenogastric reflux on Helicobacter pylori infection and drug resistance in children in Wuxi area

作　　者：王旭阳 林琼[2] Wang Xuyang;Lin Qiong(Department of Pediatric Gastroenterology,Wuxi People′s Hospital Affiliated to Nanjing Medical University,Wuxi 214000,China;Department of Gastroenterology,Wuxi Children′s Hospital Affiliated to Nanjing Medical University,Children′s Hospital Affiliated to Jiangnan University,Wuxi 214000,China)

机构地区：[1]南京医科大学附属无锡人民医院儿消化内科,214000 [2]南京医科大学附属无锡市儿童医院,江南大学附属儿童医院消化科,214000

出　　处：《中国小儿急救医学》2023年第3期199-202,共4页Chinese Pediatric Emergency Medicine

基　　金：无锡市卫生健康委妇幼健康科研项目(FYKY202108)。

摘　　要：目的探讨江苏省无锡地区儿童原发性十二指肠胃反流(DGR)对幽门螺杆菌(HP)感染及耐药性的影响,为后续DGR患儿抗HP药物的选择提供依据。方法收集2020年1月至2022年2月,因腹痛、恶心、呕吐、消化道出血、消化不良等上消化道症状就诊于无锡市儿童医院消化科门诊且接受了上消化道内镜检查和HP检查的患儿临床资料。根据胃镜检查结果,分为DGR组(217例)和不伴DGR的对照组(1252例),对其年龄、性别、HP感染率及腹痛等情况进行分析。结果共纳入1469例患儿,中位年龄11(9,14)岁,男808例(55.0%),女661例(45.0%)。HP感染共检出322例(21.9%)。DGR组患儿中位年龄高于对照组[13(11,15)岁比11(8,14)岁,P<0.001];不同年龄段间DGR发病率比较,差异有统计学意义,高年龄段DGR发病率增加(χ^(2)=45.963,P<0.001)。DGR组与对照组患儿在性别及是否以腹痛为首发症状方面差异均无统计学意义(P>0.05)。DGR组患儿检出HP阳性47例(22.0%),对照组检出HP阳性275例(22.0%),差异无统计学意义(P>0.05)。HP分离培养阳性并行菌株体外药敏试验256例,发现HP对甲硝唑、克拉霉素、左氧氟沙星、阿莫西林、呋喃唑酮及盐酸四环素的单一及联合耐药率在两组间差异均无统计学意义(P>0.05)。结论大龄儿童更易发生原发性DGR。DGR对HP的感染及耐药性没有显著影响。Objective To investigate the effect of primary duodenal bile reflux(DGR)on Helicobacter pylori(HP)infection and drug resistance in children in Wuxi area,and to provide the basis for the selection of anti-HP drugs in children with subsequent DGR.Methods The clinical data of children who had received upper gastrointestinal endoscopy and HP examination because of abdominal pain,nausea,vomiting,gastrointestinal bleeding,dyspepsia and other upper gastrointestinal symptoms were collected from January 2020 to February 2022 in the Gastroenterology Department of Wuxi Children′s Hospital.According to the results of endoscopy,children were divided into DGR group(217 cases)and control group without DGR(1252 cases),and their age,gender,HP infection rate and abdominal pain were analyzed.Results A total of 1469 children were included in this study,with a median age of 11(9,14)years,808(55.0%)males and 661(45.0%)females.HP infection was detected in 322(21.9%)cases.The median age of DGR group was higher than that in control group[13(11,15)years vs.11(8,14)years,P<0.001],and the incidence of DGR was increased in the elder group(χ^(2)=45.963,P<0.001).There was no significant difference between DGR group and control group in sex and whether abdominal pain was the first symptom(P>0.05).There were 47(22.0%)cases positive for HP in DGR group and 275(22.0%)cases in control group,with no significant difference(P>0.05).A total of 256 cases were isolated and cultured positive of HP.And in vitro susceptibility tests of strains,there was no significant difference between DGR group and control group in the single and combined resistance rates of HP to metronidazole,clarithromycin,levofloxacin,amoxicillin,furazolidone and tetracycline hydrochloride(P>0.05).Conclusion Elder children are more likely to have primary DGR.The occurrence of primary DGR has no significant effect on HP infection and drug resistance.

关 键 词：十二指肠胃反流 儿童 幽门螺杆菌 耐药性 

分 类 号：R725.7[医药卫生—儿科]