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儿童非溃疡性消化不良与幽门螺杆菌根除

Nonulcer dyspepsia and Helicobacter pylori eradication in children.

作者信息

Farrell Stephen, Milliken Irene, Murphy Jane L, Wootton Steve A, McCallion William A

机构信息

Department of Child Health, Institute of Clinical Science, Queen's University, Belfast BT12 6BJ, Northern Ireland.

出版信息

J Pediatr Surg. 2005 Oct;40(10):1547-50. doi: 10.1016/j.jpedsurg.2005.06.027.

Abstract

BACKGROUND

Controversy exists over Helicobacter pylori eradication therapy in the treatment of patients with nonulcer dyspepsia. The lack of pediatric studies has made it difficult to draw conclusions about the use of eradication in dyspeptic children. The aim of this study was to examine long-term symptom severity in pediatric patients with nonulcer dyspepsia and H pylori gastritis after H pylori eradication.

METHODS

Thirty-nine children (mean age, 9.0 years) with dyspepsia and H pylori gastritis were prospectively recruited. Severity of symptoms was graded before H pylori eradication. Each patient was followed up at 6, 12, and on average, 61.6 months after eradication, with reassessment of symptoms and H pylori status.

RESULTS

There was a significant reduction in the severity of symptoms at 6 and 12 months, and at long-term follow-up compared with the preeradication scores (all P < . 001). At long-term follow-up, reinfection with H pylori was associated with more severe symptoms than if the patients remained free of infection (P = .045).

CONCLUSIONS

This study has demonstrated a significant long-term improvement in nonulcer dyspepsia in children after eradication of H pylori. This provides further evidence for the consideration of H pylori eradication in pediatric patients presenting with nonulcer dyspepsia.

摘要

背景

幽门螺杆菌根除疗法在治疗非溃疡性消化不良患者方面存在争议。由于缺乏儿科研究,难以就消化不良儿童使用根除疗法得出结论。本研究的目的是检查幽门螺杆菌根除后患有非溃疡性消化不良和幽门螺杆菌胃炎的儿科患者的长期症状严重程度。

方法

前瞻性招募了39名患有消化不良和幽门螺杆菌胃炎的儿童(平均年龄9.0岁)。在根除幽门螺杆菌之前对症状严重程度进行分级。在根除后6个月、12个月以及平均61.6个月对每位患者进行随访,重新评估症状和幽门螺杆菌状态。

结果

与根除前评分相比,在6个月和12个月时以及长期随访时症状严重程度显著降低(所有P <.001)。在长期随访中,幽门螺杆菌再次感染的患者比未感染的患者症状更严重(P = 0.045)。

结论

本研究表明根除幽门螺杆菌后儿童非溃疡性消化不良有显著的长期改善。这为考虑对患有非溃疡性消化不良的儿科患者进行幽门螺杆菌根除提供了进一步的证据。

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