Zawadzka-Gralec Anna, Wróblewska Małgorzata, Szaflarska-Popławska Anna, Mierzwa Grazyna, Parzecka Monika, Bała Grazyna, Slusarska-Kopala Jadwiga, Czerwionka-Szaflarska Mieczysława
Uniwersytet Mikołaja Kopernika w Toruniu, Collegium Medicum w Bydgoszczy, Katedra i Klinika Pediatrii, Alergologii i Gastroenterologii.
Pol Merkur Lekarski. 2009 Jan;26(151):24-8.
A diagnostics of Helicobacter pylori infection in children and adolescents in practice sometimes is still difficult. Qualification to the tests for detecting infection with invasive and noninvasive methods should start from diligent anamnesis.
Is to present the clinical course and results of diagnostic tests in children and adolescents with suspicion of Helicobacter pylori infection.
One hundred patients aged between 18 months and 18 years who underwent endoscopy with gastric biopsies, histology, culture and 13carbon urea breath test. There were 36 boys and 64 girls in analysed group, 10% of them were preschool children, 42% school children and 48% teenagers older than 12 years
Patients were symptomatic and most frequent were dyspeptic symptoms (91%). A symptom duration time was varied from several days to several years. On the basis of endoscopy and histology gastritis and/or duodenitis were found in 92 patients, esophagitis and gastritis in 5 patients, duodenal ulcer in 2 patients, in 1 case gastric and duodenal mucosa was normal. Helicobacter pylori infection was histopathologically confirmed in 37 patients. In 15 cases Helicobacter pylori strains were isolated with full in vitro sensitivity to amoxicillin, claritromycin and metronidazol. Urea breath test was conducted in 85 analyzed patients and 51 of them had abnormal result.
In clinical picture of Helicobacter infection most frequent were dyspepstic symptoms and by endoscopy chronic gastritis and/or duodenitis were shown. Culture of Helicobacter pylori has a limited usefulness in practice especially in patients who underwent antibiotic/eradication therapy. The statistical significant concordance occurred between culture and noninvasive 13carbon urea breath test.
在实际临床中,诊断儿童和青少年幽门螺杆菌感染有时仍然困难。采用侵入性和非侵入性方法检测感染的检测资格应始于详尽的问诊。
旨在呈现疑似幽门螺杆菌感染的儿童和青少年的临床病程及诊断测试结果。
100例年龄在18个月至18岁之间的患者接受了胃镜检查及胃活检、组织学检查、培养和13碳尿素呼气试验。分析组中有36名男孩和64名女孩,其中10%为学龄前儿童,42%为学龄儿童,48%为12岁以上青少年。
患者有症状,最常见的是消化不良症状(91%)。症状持续时间从几天到几年不等。根据胃镜检查和组织学检查,92例患者发现胃炎和/或十二指肠炎,5例患者发现食管炎和胃炎,2例患者发现十二指肠溃疡,1例患者胃和十二指肠黏膜正常。37例患者经组织病理学证实有幽门螺杆菌感染。15例患者分离出幽门螺杆菌菌株,对阿莫西林、克拉霉素和甲硝唑具有完全体外敏感性。对85例分析患者进行了尿素呼气试验,其中51例结果异常。
在幽门螺杆菌感染的临床表现中,最常见的是消化不良症状,胃镜检查显示为慢性胃炎和/或十二指肠炎。幽门螺杆菌培养在实际应用中的作用有限,尤其是在接受过抗生素/根除治疗的患者中。培养结果与非侵入性13碳尿素呼气试验之间存在统计学上的显著一致性。