Oztürk H, Senocak M E, Uzunalimoğlu B, Hasçelik G, Büyükpamukçu N, Hiçsönmez A
Department of Pediatric Surgery, Hacettepe University, Medical Faculty, Ankara, Turkey.
Eur J Pediatr Surg. 1996 Oct;6(5):265-9. doi: 10.1055/s-2008-1066524.
It is well known that Helicobacter pylori infection is extremely common throughout the world, but most infected persons do not develop ulceration and remain asymptomatic. This study was undertaken in order to determine the prevalence of H. pylori infection, the age distribution, and the factors that may affect the frequency of H. pylori infection. We evaluated the presence of antibody against H. pylori in children and adolescents, we also assessed the efficacy of non-invasive and invasive methods for detection of H. pylori infection in children who had undergone upper gastrointestinal endoscopy. We evaluated 43 males and 18 females whose ages ranged from 1 to 17 years (mean age: 9.4 +/- 4.2). 29 of all cases were symptomatic and 32 were asymptomatic. H. pylori infection was present in 49% of the studied cases. The data were analysed by Fisher's exact chi-square and Mantel-Haenszel tests. It was found that H. pylori infection graphically increased with age in both groups from 25% at ages 3-5 to 80% at ages 16-20. But no association was determined statistically between age and H. pylori positivity (p < 0.05). H. pylori infection was determined in 14 (48%) and 16 (50%) cases in symptomatic and asymptomatic groups respectively. There was no significant difference between H. pylori and either group (p > 0.05). According to the endoscopy findings, the symptomatic group was divided into two subgroups: children with peptic ulcer and children with non-ulcer dyspepsia (NUD). An attempt was made to compare ulcer, non ulcer dyspepsia and asymptomatic cases with H. pylori positivity, but no significant relation could be established between the groups (p > 0.05). 14 (23%) of the cases had previous gastric and/or intestinal complaints in their parents (positive family history). There was a significant, statistically positive relation between family history and symptoms (p < 0.01). Nevertheless, no association was found between H. pylori infection and family history (p > 0.05). There were no significant differences in H. pylori infection related to sex, type of housing, location of housing, socio-economic status (SES) or source of water supply. It is concluded that H. pylori infection has a high prevalence in our country. Although endoscopic evaluation is an invasive method, under our conditions, histopathological examination with 97% is shown to be much more sensitive in determination of H. pylori infection. Since no community difference was determined in the prevalence of H. pylori infection, all children should be considered to be under the threat of the same risk.
众所周知，幽门螺杆菌感染在全球极为常见，但大多数感染者不会发生溃疡，且无症状。本研究旨在确定幽门螺杆菌感染的患病率、年龄分布以及可能影响幽门螺杆菌感染频率的因素。我们评估了儿童和青少年中抗幽门螺杆菌抗体的存在情况，还评估了在接受上消化道内镜检查的儿童中检测幽门螺杆菌感染的非侵入性和侵入性方法的有效性。我们评估了43名男性和18名女性，年龄范围为1至17岁（平均年龄：9.4±4.2）。所有病例中29例有症状，32例无症状。在所研究的病例中，49%存在幽门螺杆菌感染。数据采用Fisher精确卡方检验和Mantel-Haenszel检验进行分析。结果发现，两组中幽门螺杆菌感染率均随年龄增长而显著上升，从3至5岁时的25%升至16至20岁时的80%。但年龄与幽门螺杆菌阳性之间未发现统计学关联（p<0.05）。有症状组和无症状组中分别有14例（48%）和16例（50%）检测出幽门螺杆菌感染。幽门螺杆菌感染与两组中的任何一组之间均无显著差异（p>0.05）。根据内镜检查结果，有症状组分为两个亚组：消化性溃疡患儿和非溃疡性消化不良（NUD）患儿。试图比较溃疡、非溃疡消化不良和无症状病例的幽门螺杆菌阳性情况，但各亚组之间未发现显著关联（p>0.05）。14例（23%）病例的父母有既往胃和/或肠道疾病史（家族史阳性）。家族史与症状之间存在显著的统计学正相关（p<0.01）。然而，未发现幽门螺杆菌感染与家族史之间存在关联（p>0.05）。幽门螺杆菌感染在性别、住房类型、住房位置、社会经济地位（SES）或水源方面无显著差异。结论是，我国幽门螺杆菌感染患病率较高。虽然内镜评估是一种侵入性方法，但在我们的条件下，组织病理学检查显示在确定幽门螺杆菌感染方面敏感性高达97%，要高得多。由于未发现幽门螺杆菌感染患病率存在社区差异，所有儿童都应被视为面临相同风险的威胁。
