Maaroos H I, Rägo T, Sipponen P, Siurala M
Dept. of Internal Medicine, Tartu University, Estonia.
Scand J Gastroenterol Suppl. 1991;186:95-9.
Gastroscopy with biopsies was performed in 178 children with upper abdominal pain. Of them 109 (61%) had gastritis and 104 (58%) Helicobacter pylori (HP) in antrum and/or corpus. Gastritis consisted in most cases (87% of antral and 86% of corpus gastritis) of mild superficial round cell infiltration. Mucosal atrophy was not found. Accumulation of granulocytes was present in 43 patients and lymphonoduli were found in 33 patients, usually in connection with gastritis. Gastritis affected only the antrum in 18%, only the corpus in 5% and both antrum and corpus in 62% of the cases of gastritis. There was a good correlation between morphology and bacteriology in the antrum and a satisfactory one in the corpus. However, in some cases gastritis was present without bacteria and in some cases a normal mucosa was associated with bacteria. Gastritis and HP prevalences showed a general increasing trend with age, but significances were with one exception lacking. It is tentatively concluded that gastritis begins in childhood as a slight and chronic superficial infiltration affecting usually antrum and corpus simultaneously. In the majority of cases gastritis is associated with HP infection, which seems to start the process. It is possible that the HP-related gastritis is a common cause of abdominal complaints in children; however, convincing evidence is lacking.
对178名有上腹部疼痛的儿童进行了胃镜检查及活检。其中109名（61%）患有胃炎，104名（58%）胃窦和/或胃体存在幽门螺杆菌（HP）。胃炎在大多数情况下（胃窦胃炎的87%和胃体胃炎的86%）表现为轻度浅表性圆形细胞浸润。未发现黏膜萎缩。43例患者存在粒细胞聚集，33例患者发现淋巴小结，通常与胃炎有关。胃炎仅累及胃窦的占18%，仅累及胃体的占5%，胃窦和胃体均受累的占胃炎病例的62%。胃窦部的形态学与细菌学之间有良好的相关性，胃体部的相关性也令人满意。然而，在某些情况下，胃炎存在但无细菌，而在某些情况下，正常黏膜与细菌并存。胃炎和HP的患病率总体上随年龄呈上升趋势，但除一个例外均无统计学意义。初步得出结论，胃炎在儿童期开始时为轻度慢性浅表性浸润，通常同时累及胃窦和胃体。在大多数情况下，胃炎与HP感染有关，HP感染似乎启动了这一过程。HP相关胃炎可能是儿童腹部不适的常见原因；然而，缺乏确凿证据。
