Oderda Giuseppina, Shcherbakov Peter, Bontems Patrick, Urruzuno Pedro, Romano Claudio, Gottrand Frederic, Gómez M Jose Martinez, Ravelli Alberto, Gandullia Paolo, Roma Elefteria, Cadranel Sami, De Giacomo Costantino, Canani Roberto Berni, Rutigliano Vincenzo, Pehlivanoglu Ender, Kalach Nicolas, Roggero Paola, Celinska-Cedro Danuta, Drumm Brendan, Casswall Thomas, Ashorn Marja, Arvanitakis Sanda Nousia
University of Piemonte Orientale, Novara, Italy.
Helicobacter. 2007 Apr;12(2):150-6. doi: 10.1111/j.1523-5378.2007.00485.x.
Data on the eradication treatment for childhood Helicobacter pylori are scanty. A register was established on the European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) website to collect data on treatment performed by European pediatricians to ascertain what is practiced in the field.
From January 2001 to December 2002, information on 597 children were entered by 23 European Centers, but only data of 518 treated children were completed and analyzed (86.7%, 262 male subjects, median age 9 years, range 1-14). According to their nationality, 226 children were from Southern Europe, 132 from Eastern Europe, 68 from Western Europe, and 4 from northern Europe, 68 from North Africa, and 20 from Asia. At endoscopy, 454 children had gastritis and 64 had ulcer (12.3%). Antibiotic sensitivity, tested in 361 cases, revealed 18% clarithromycin-resistant and 19% metronidazole-resistant H. pylori strains.
Treatment was performed for 1 week in 388 and for 2 weeks in 130 children. Antibiotics were associated with proton pump inhibitors (PPI) in 345 and with bismuth in 121 children. Triple therapy was given to 485 children, dual therapy to 26, quadruple to 7. Follow-up data, by (13)C-Urea-Breath Test or histology or both, were available for 480 children. Overall eradication rate was 65.6%, significantly higher in children with ulcer (79.7%) than without (63.9%, p = .001). When given as first treatment, bismuth-containing triple therapies were more efficacious than PPI-containing ones (77% versus 64%, p = .02, OR 1.88, 95% CI 1.1-3.3). Twenty-seven different treatment regimens were used, but only six were administered to at least 18 children (range 18-157). There was no difference between treatments given for 1 or 2 weeks, or given as first or second therapies.
European pediatricians entering data in the register used 27 different regimens. Bismuth-containing therapies resulted in higher eradication rate. Omeprazole-containing triple therapies were the most used although their efficacy was low. Therapies recommended for adults do not appear to be suitable for children.
关于儿童幽门螺杆菌根除治疗的数据较少。在欧洲儿科胃肠病学、肝病学和营养学会（ESPGHAN）网站上建立了一个登记册，以收集欧洲儿科医生进行治疗的数据，从而确定该领域的实际治疗情况。
2001年1月至2002年12月，23个欧洲中心录入了597名儿童的信息，但仅对518名接受治疗儿童的数据进行了完整分析（86.7%，男性262名，中位年龄9岁，范围1 - 14岁）。根据国籍，226名儿童来自南欧，132名来自东欧，68名来自西欧，4名来自北欧，68名来自北非，20名来自亚洲。内镜检查时，454名儿童患有胃炎，64名患有溃疡（12.3%）。在361例病例中检测的抗生素敏感性显示，18%的幽门螺杆菌菌株对克拉霉素耐药，19%对甲硝唑耐药。
388名儿童接受了1周的治疗，130名儿童接受了2周的治疗。345名儿童的抗生素与质子泵抑制剂（PPI）联合使用，121名儿童的抗生素与铋剂联合使用。485名儿童接受了三联疗法，26名接受了双联疗法，7名接受了四联疗法。480名儿童可获得通过（13）C -尿素呼气试验或组织学或两者进行的随访数据。总体根除率为65.6%，患有溃疡的儿童（79.7%）的根除率显著高于未患溃疡的儿童（63.9%，p = 0.001）。作为首次治疗时，含铋三联疗法比含PPI三联疗法更有效（77%对64%，p = 0.02，OR 1.88，95% CI 1.1 - 3.3）。使用了27种不同的治疗方案，但只有6种方案至少应用于18名儿童（范围18 - 157）。1周或2周的治疗以及首次或第二次治疗之间没有差异。
在登记册中录入数据的欧洲儿科医生使用了27种不同的方案。含铋疗法的根除率更高。含奥美拉唑的三联疗法使用最多，但其疗效较低。推荐给成人的疗法似乎不适用于儿童。
