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儿童幽门螺杆菌感染:诊断方法概述。

Helicobacter pylori infection in children: an overview of diagnostic methods.

机构信息

Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran.

Scientist Biopharmaceutical Development Medimmune Gaithersburg, Gaithersburg, MD, 20878, USA.

出版信息

Eur J Clin Microbiol Infect Dis. 2019 Jun;38(6):1035-1045. doi: 10.1007/s10096-019-03502-5. Epub 2019 Feb 7.

Abstract

Children differ from adults regarding Helicobacter pylori (H. pylori) infection in many terms. H. pylori infection represents a key factor in the pathogenesis of duodenal ulcer and chronic gastritis in children. H. pylori infection causes some extraintestinal diseases as well as gastrointestinal diseases. Although, among these illnesses in children, symptoms like recurrent abdominal pain are not specific. Moreover, the role of the pathogen in the growth faltering, iron deficiency anemia, and asthma still remains controversial. A reliable method to detect H. pylori infection is a crucial issue, sand is still a matter of active debate. The tests applied for H. pylori diagnosis are grouped as either invasive or non-invasive methods. Invasive methods consist of endoscopic evaluation, the rapid urease test (RUT), histology, and bacterial culture. Non-invasive tests include the urea breath test (UBT), stool antigen test (SAT), serology, and molecular diagnostic approaches. Use of endoscopy is a pre-requisite for all invasive methods and poses difficulties in children as it is a difficult procedure and requires patient's cooperation. For this reason, the non-invasive tests have been commonly used in children, although their accuracy is not very reliable in some cases. Invasive tests may be opted to confirm the diagnosis as and when needed. This review presents the diagnostic tests used to detect H. pylori infection in children.

摘要

儿童的幽门螺杆菌(H. pylori)感染在许多方面与成人不同。H. pylori 感染是儿童十二指肠溃疡和慢性胃炎发病机制中的关键因素。H. pylori 感染会引起一些胃肠道疾病和肠道外疾病。尽管在这些儿童疾病中,反复腹痛等症状并不具有特异性。此外,病原体在生长发育迟缓、缺铁性贫血和哮喘中的作用仍存在争议。检测 H. pylori 感染的可靠方法是一个关键问题,目前仍存在争议。用于 H. pylori 诊断的检测方法可分为侵袭性和非侵袭性方法。侵袭性方法包括内镜评估、快速尿素酶试验(RUT)、组织学和细菌培养。非侵袭性检测包括尿素呼气试验(UBT)、粪便抗原检测(SAT)、血清学和分子诊断方法。所有侵袭性方法都需要进行内镜检查,这对儿童来说是一个困难的程序,因为它需要患者的配合。因此,非侵袭性检测在儿童中更为常用,尽管在某些情况下其准确性并不十分可靠。在需要时可选择侵袭性检测来确诊。本文综述了用于检测儿童 H. pylori 感染的诊断检测方法。

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