陕西农村地区儿童幽门螺杆菌感染的危险因素调查及与慢性肠系膜淋巴结炎的相关性研究  

Risk factor analysis of pediatric Helicobacter pylori infection of rural areas in Shaanxi Province and its correlation with chronic mesenteric lymphadenitis

作　　者：狄佳[1] 吴涛[1] 吴金鑫 马小东 钟瑜 夏茜 常丹燕[4] 郑向红[1] DI Jia;WU Tao;WU Jinxin;MA Xiaodong;ZHONG Yu;XIA Qian;CHANG Danyan;ZHENG Xianghong(Department of Nuclear Medicine,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710004,China;Department of Laboratory,Zizhou County Hospital of Traditional Chinese Medicine;Department of Physical Examination,Mian County Hospital of Traditional Chinese Medicine;Department of Gastroenterology,the Second Affiliated Hospital of Xi'an Jiaotong University)

机构地区：[1]西安交通大学第二附属医院核医学科,西安710004 [2]陕西子洲县中医院检验科 [3]陕西勉县中医院体检科 [4]西安交通大学第二附属医院消化内科

出　　处：《中国中西医结合消化杂志》2024年第6期518-525,共8页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：中国博士后科学基金面上项目(No:2022M712556);陕西省自然科学基金基础研究计划青年项目(No:2022JQ-838);西安交通大学第二附属医院医疗新技术基金(No:XJEFY-015)。

摘　　要：目的:调查陕西农村地区儿童幽门螺杆菌(Helicobacter pylori,HP)感染的流行病学特征及筛选独立危险因素,并探讨HP感染与慢性肠系膜淋巴结炎(mesenteric lymphadenitis,MLN)的关系。方法:收集2020年9月—2023年10月就诊于西安交通大学第二附属医院、陕西子洲县中医院、陕西勉县中医院进行13C尿素呼气试验儿童的临床资料,完成HP感染基本情况分析、HP感染与慢性MLN患病特点分析、HP感染危险因素logistic回归分析、HP感染与慢性MLN相关性logistic回归分析。结果:本研究共纳入陕西省北、中、南部农村地区儿童709例,其中HP阳性329例,阴性380例,HP感染率为46.40%;慢性MLN患儿112例,无慢性MLN 597例,MLN患病率为15.80%。HP感染基本情况分析显示,各年龄段HP感染率比较均差异有统计学意义(均P<0.001),>15~18岁儿童HP感染率最高;男童HP感染率显著高于女童,差异有统计学意义(P<0.01);西安市农村地区儿童HP感染率显著高于榆林市及汉中市,均差异有统计学意义(均P<0.01);共用刷牙口杯、共用餐具、无饭前便后洗手习惯、喜食零食、直系亲属有胃肠病史及家庭人口≥4人的儿童HP感染率均显著高于无上述习惯的儿童(均P<0.001)。HP感染与慢性MLN患病特点分析显示,HP感染患儿的白细胞计数、单核细胞计数、C反应蛋白、降钙素原、IL-6、免疫球蛋白G、补体C3、补体C4显著升高,CD3^(+)计数、CD4^(+)计数、CD8^(+)计数显著降低(均P<0.05);紫癜患儿HP感染率显著高于贫血与口腔溃疡患儿(均P<0.05);HP感染患儿腹腔淋巴结最大短径、肠壁水肿及腹腔液性暗区深度显著增加(均P<0.01);慢性MLN患儿C反应蛋白、降钙素原、免疫球蛋白G、补体C3、补体C4、CD4^(+)计数、CD8^(+)计数、CD4^(+)/CD8^(+)比值显著高于无慢性MLN儿童(均P<0.05);贫血、口腔溃疡、发育缓慢患儿的MLN患病率相当,并显著高于其他患儿,均差异有统计学意义(均P<0.05);慢Objective To investigate the epidemiological characteristics and independent risk factors of pediatric Helicobacter pylori(HP)infection in rural areas of Shaanxi Province,and to explore the correlation between HP infection and chronic mesenteric lymphadenitis(MLN).Methods To collect clinical information from children who had 13C urea breath tests in the Second Affiliated Hospital of Xi'an Jiaotong University(Xi'an),Zizhou County Traditional Chinese Medicine Hospital(Yulin),and Mian County Traditional Chinese Medicine Hospital(Hanzhong)from September 2020 to October 2023.We completed the logistic regression analyses of risk factors for HP infection and the association between HP infection and chronic MLN,as well as the basic analyses of HP infection and the characteristics of chronic MLN.Results The study included a total of 709 rural children in the northern,central,and southern regions of Shaanxi Province,including 329 HP-positive cases and 380 HP-negative cases.The HP infection rate was 46.40%.There were 112 children with chronic MLN and 597 children without chronic MLN,and the prevalence of MLN was 15.80%.The basic study of HP infection revealed significant differences in HP infection rates among different age groups(all P<0.001).The age group of>15 to 18 years old had the greatest infection rate among the minors.The prevalence of HP infection in rural boys in Xi'an was substantially greater than that in girls(P<0.01).Compared to Yulin and Hanzhong,the infection rate among rural children in Xi'an was also considerably higher(both P<0.01).Children with a family size of less than four,those who shared toothbrush cups,shared tableware,did not wash their hands before and after using the restroom,enjoyed snacking,and had immediate relatives with a history of gastrointestinal illness,achieved a significantly higher rate of HP infection(all P<0.001).Analysis of characteristics of HP infection and chronic MLN showed that children with HP had significantly higher counts of white blood cells,monocytes,C-reactive protein

关 键 词：幽门螺杆菌 儿童 肠系膜淋巴结炎 危险因素 

分 类 号：R573.6[医药卫生—消化系统]