Egbaria Rania, Levine Arie, Tamir Ada, Shaoul Ron
Department of Pediatrics, Bnai Zion Medical Center, Faculty of Medicine, Technion, Haifa, Israel.
Helicobacter. 2008 Feb;13(1):62-8. doi: 10.1111/j.1523-5378.2008.00570.x.
Peptic ulcers and erosions (PU&E) are thought to be uncommon in children. Patients with early exposure to Helicobacter pylori may be at a higher risk for early onset PU&E. Children in Israel have a high prevalence and early acquisition of Helicobacter pylori (H. pylori) and have easy access to pediatric gastroenterologists and endoscopy. Our aim was to describe the prevalence and characteristics of PU&E in this population referred by Pediatric Gastroenterologists for an upper endoscopy.
We conducted a retrospective study over the years January 2003-May 2006. Over these years we had information on 751 diagnostic upper endoscopies. PU&E was regarded as erosive gastritis/duodenitis or ulcer in either the stomach or duodenum. H. pylori status was assessed using rapid urease test and gastric biopsies.
PU&E was detected in 169 (22.5%) patients (ulcers 51 (6.8%), erosions 118 (15.7%)). One hundred twenty-four had gastric PU&E and 58 had duodenal PU&E. H. pylori was positive in 112 (66.3%). H. pylori-associated PU&E becomes common after age 10 years, with gastric PU&E presenting much earlier than duodenal disease. Most of the H. pylori-negative PU&E were idiopathic and improved symptomatically on PPI treatment. Interestingly, 43% of patients with PU&E in our cohort were either immigrants from the former Soviet Union or of Israeli Arab origin.
PU&E appears to be common in this selected population with a relatively high incidence of gastric PU&E. H. pylori associated PU&E becomes common after age 10 years with gastric PU&E presenting much earlier than duodenal disease. Non H. pylori PU&E in children comprises approximately a third of all PU&E, are mostly idiopathic and appear earlier than H. pylori associated PU&E.
消化性溃疡和糜烂（PU&E）在儿童中被认为并不常见。早期接触幽门螺杆菌的患者发生早期PU&E的风险可能更高。以色列儿童幽门螺杆菌（H. pylori）的感染率高且感染时间早，并且很容易获得儿科胃肠病专家的诊治及接受内镜检查。我们的目的是描述由儿科胃肠病专家转诊进行上消化道内镜检查的这一人群中PU&E的患病率及特征。
我们对2003年1月至2006年5月期间进行了回顾性研究。在这些年里，我们有751例诊断性上消化道内镜检查的相关信息。PU&E被视为胃或十二指肠的糜烂性胃炎/十二指肠炎或溃疡。使用快速尿素酶试验和胃活检评估H. pylori感染状况。
在169例（22.5%）患者中检测到PU&E（溃疡51例（6.8%），糜烂118例（15.7%））。124例有胃PU&E，58例有十二指肠PU&E。112例（66.3%）H. pylori检测呈阳性。H. pylori相关的PU&E在10岁后变得常见，并以胃PU&E比十二指肠疾病出现得更早。大多数H. pylori阴性的PU&E是特发性的，在接受质子泵抑制剂（PPI）治疗后症状改善。有趣的是，我们队列中43%的PU&E患者要么是前苏联移民，要么是以色列阿拉伯裔。
在这一特定人群中，PU&E似乎很常见，胃PU&E的发病率相对较高。H. pylori相关的PU&E在10岁后变得常见，胃PU&E比十二指肠疾病出现得更早。儿童非H. pylori相关的PU&E约占所有PU&E的三分之一，大多是特发性的，并且比H. pylori相关的PU&E出现得更早。
