Tomić Teo, Persić Mladen, Rajić Borko, Tomić Zeljka
Clinic for Children's Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.
Coll Antropol. 2009 Dec;33 Suppl 2:53-7.
Infection with Helicobacter pylori (Hp) is common in children from developing countries, particularly in adolescents. It is associated with chronic gastritis and stomach cancer. A characteristic endoscopic finding in children is nodular gastritis. The aim of this study was to assess and confirm association of nodular gastritis, mainly of anthral mucosa, with Hp infection in children. A total of 195 children 1 to 15 years of age were studied during a two-year period (2004-2006). There were 107 girls (54.9%) and 88 boys (45.1%). The patients presented with recurrent epigastric pain, nausea, vomiting, heartburn, sour mouth, regurgitation, bloating or other dyspeptic symptoms. The complaints were recorded by a structured interview with parents and older children. Upper endoscopy was performed in all children. The presence and degree of mucosal granulation was recorded and two samples of mucousa from the antrum and the small curvature were taken. Biopsy material was processed for histology as usual, stained with 2% Giemsa and examined by a pathologist for the presence of Hp. A total of 40 of 195 children (20.5%) have had positive Hp infection and a 27 of 40 (67.5%) have had a granular aspect of anthral mucosa at the endoscopy. Sensitivity of the finding was 87.5%, specificity 93.5%, positive predictive value 73%, negative predictive value 91.8%, p < 0.05. Average age of those patients was 11.5 +/- 3.0 years. Subjective symptoms of dyspepsia (as recorded by the questionnaire) were often associated with Hp positivity, but short of statistical significance. No difference between boys and girls was noted. Endoscopic finding of nodular gastritis, especially in areas of antrum and small curvature, showed a highly positive correlation with Hp infection.
幽门螺杆菌（Hp）感染在发展中国家儿童中很常见，尤其是在青少年中。它与慢性胃炎和胃癌有关。儿童内镜检查的一个特征性发现是结节性胃炎。本研究的目的是评估并确认主要累及胃窦黏膜的结节性胃炎与儿童Hp感染之间的关联。在两年期间（2004 - 2006年）共研究了195名1至15岁的儿童。其中有107名女孩（54.9%）和88名男孩（45.1%）。这些患者表现为反复上腹部疼痛、恶心、呕吐、烧心、口苦、反流、腹胀或其他消化不良症状。通过对家长和年龄较大儿童进行结构化访谈来记录这些症状。所有儿童均接受了上消化道内镜检查。记录黏膜颗粒化的存在情况和程度，并从胃窦和小弯处采集两份黏膜样本。活检材料按常规进行组织学处理，用2%吉姆萨染色，由病理学家检查是否存在Hp。195名儿童中有40名（20.5%）Hp感染呈阳性，其中40名中的27名（67.5%）在内镜检查时胃窦黏膜有颗粒样表现。该发现的敏感性为87.5%，特异性为93.5%，阳性预测值为73%，阴性预测值为91.8%，p<0.05。这些患者的平均年龄为11.5±3.0岁。消化不良的主观症状（如问卷所记录）常与Hp阳性相关，但缺乏统计学意义。未发现男孩和女孩之间存在差异。结节性胃炎的内镜检查发现，尤其是在胃窦和小弯区域，与Hp感染呈高度正相关。
