Frank F, Stricker T, Stallmach T, Braegger C P
Department of Pediatric Gastroenterology and Nutrition, University Children's Hospital, Zürich, Switzerland.
J Pediatr Gastroenterol Nutr. 2000 Oct;31(4):424-7. doi: 10.1097/00005176-200010000-00017.
Helicobacter pylori is associated with chronic gastritis and peptic ulcer in adults and in children. The purpose of the present study was to analyze the association of recurrent abdominal pain and H. pylori infection in children and to evaluate the efficacy of antimicrobial treatment in patients with evidence of infection.
The clinical and histopathologic findings in children who underwent diagnostic upper endoscopy for recurrent abdominal pain were analyzed retrospectively. Patients with evidence of infection with H. pylori were treated with a combination of omeprazole, amoxicillin, and clarithromycin. Efficacy of treatment was assessed using the 13C-urea-breath test.
H. pylori was found in histopathologic sections of 29 (40%) of 73 patients undergoing diagnostic endoscopy for recurrent abdominal pain. Five children (17%) were of Swiss ethnic origin, and 24 (83%) were non-Swiss. All the infected patients had chronic gastritis and 4 (14%) had ulcerations in the duodenum. Treatment with omeprazole, amoxicillin, and clarithromycin resulted in eradication of the infection in all and in resolution of the clinical symptoms in 15 (80%) of 19 patients who had a follow-up examination.
The presented data suggest that gastritis induced by H. pylori may be associated with recurrent abdominal pain and that in Switzerland infections with H. pylori primarily involve persons who are non-Swiss. A combined therapy results in eradication of the bacterium and in improvement of the clinical symptoms in a significant majority of the patients.
幽门螺杆菌与成人及儿童的慢性胃炎和消化性溃疡有关。本研究的目的是分析儿童复发性腹痛与幽门螺杆菌感染之间的关联，并评估对有感染证据的患者进行抗菌治疗的疗效。
回顾性分析因复发性腹痛接受诊断性上消化道内镜检查的儿童的临床和组织病理学结果。有幽门螺杆菌感染证据的患者接受奥美拉唑、阿莫西林和克拉霉素联合治疗。使用13C尿素呼气试验评估治疗效果。
在73例因复发性腹痛接受诊断性内镜检查的患者中，29例（40%）的组织病理学切片中发现了幽门螺杆菌。5名儿童（17%）为瑞士裔，24名（83%）为非瑞士裔。所有感染患者均患有慢性胃炎，4例（14%）十二指肠有溃疡。奥美拉唑、阿莫西林和克拉霉素治疗使所有患者的感染得到根除，19例接受随访检查的患者中有15例（80%）临床症状得到缓解。
所提供的数据表明，幽门螺杆菌引起的胃炎可能与复发性腹痛有关，在瑞士，幽门螺杆菌感染主要累及非瑞士裔人群。联合治疗可使绝大多数患者根除细菌并改善临床症状。
