Yang Hye Ran
Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2016 Jun;19(2):96-103. doi: 10.5223/pghn.2016.19.2.96. Epub 2016 Jun 28.
Helicobacter pylori infection is acquired mainly during childhood and causes various diseases such as gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue (MALT) lymphoma, and iron deficiency anemia. Although H. pylori infection in children differs from adults in many ways, this is often overlooked in clinical practice. Unlike adults, nodular gastritis may be a pathognomonic endoscopic finding of childhood H. pylori infection. Histopathological findings of gastric tissues are also different in children due to predominance of lymphocytes and plasma cells and the formation of gastric MALT. Although endoscopy is recommended for the initial diagnosis of H. pylori infection, several non-invasive diagnostic tests such as the urea breath test (UBT) and the H. pylori stool antigen test (HpSA) are available and well validated even in children. According to recent data, both the (13)C-UBT and HpSA using enzyme-linked immunosorbent assay are reliable non-invasive tests to determine H. pylori status after eradication therapy, although children younger than 6 years are known to have high false positives. When invasive or noninvasive tests are applied to children to detect H. pylori infection, it should be noted that there are differences between children and adults in diagnosing H. pylori infection.
幽门螺杆菌感染主要在儿童期获得，并可导致多种疾病，如胃炎、消化性溃疡病、黏膜相关淋巴组织（MALT）淋巴瘤和缺铁性贫血。尽管儿童幽门螺杆菌感染在许多方面与成人不同，但在临床实践中这一点常常被忽视。与成人不同，结节性胃炎可能是儿童幽门螺杆菌感染的特征性内镜表现。由于淋巴细胞和浆细胞占优势以及胃MALT的形成，儿童胃组织的组织病理学表现也有所不同。虽然推荐内镜检查用于幽门螺杆菌感染的初始诊断，但也有几种非侵入性诊断测试，如尿素呼气试验（UBT）和幽门螺杆菌粪便抗原检测（HpSA），即使在儿童中也已得到充分验证且应用广泛。根据最近的数据，使用酶联免疫吸附测定的（13）C-UBT和HpSA都是确定根除治疗后幽门螺杆菌状态的可靠非侵入性测试，尽管已知6岁以下儿童的假阳性率较高。当应用侵入性或非侵入性测试来检测儿童幽门螺杆菌感染时，应注意在诊断幽门螺杆菌感染方面儿童与成人存在差异。
