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复发性腹痛儿童幽门螺杆菌的患病率及相关症状

The prevalence and related symptomatology of Helicobacter pylori in children with recurrent abdominal pain.

作者信息

Wewer V, Andersen L P, Paerregaard A, Gernow A B, Hart Hansen J P, Matzen P, Krasilnikoff P A

机构信息

Department of Paediatrics, Hvidovre Hospital, University of Copenhagen, Denmark.

出版信息

Acta Paediatr. 1998 Aug;87(8):830-5. doi: 10.1080/080352598750013581.

Abstract

The aim of the study was to assess and compare the IgG seroprevalence of H. pylori in children with recurrent abdominal pain with healthy children and to investigate the related symptoms. IgG antibodies against low-molecular weight H. pylori antigens were assessed in 438 children with recurrent abdominal pain and in 91 healthy controls. Sera with an ELISA unit-value above the cut-off level were confirmed by Western immunoblot. Only seropositive children with recurrent abdominal pain were examined by an oesophago-gastro-duodenoscopy. Symptomatology was recorded according to the localization of the abdominal pain, presence of pyrosis, nocturnal pain, relation of pain to meals and bowel irregularities. The seroprevalence was 21% (95% CI: 17-25%) in the children with recurrent abdominal pain and 10% (95% CI: 5-18%) in the healthy controls (p = 0.30). In seropositive children with RAP H. pylori was found in 46/66 by culture and histology. The presence of H. pylori was significantly associated with active or inactive chronic gastritis. The presence of H. pylori was associated with both parents being born in a country with a high prevalence and a low social class. Helicobacter pylori-positive children had more often pain related to meals than the H. pylori-negative children. No differences among the two groups were seen according to the levels of haemoglobin, leucocytes, thrombocytes, weight and height. In conclusion, the seroprevalence of H. pylori is comparable in children with recurrent abdominal pain and healthy children. No specific symptomatology was seen in H. pylori-positive children with RAP.

摘要

本研究的目的是评估和比较复发性腹痛儿童与健康儿童中幽门螺杆菌的IgG血清阳性率,并调查相关症状。对438名复发性腹痛儿童和91名健康对照者检测了针对低分子量幽门螺杆菌抗原的IgG抗体。酶联免疫吸附测定(ELISA)单位值高于临界值的血清通过western免疫印迹法进行确认。仅对复发性腹痛的血清阳性儿童进行了食管-胃-十二指肠镜检查。根据腹痛的部位、烧心症状、夜间疼痛、疼痛与进餐的关系以及肠道功能紊乱情况记录症状。复发性腹痛儿童的血清阳性率为21%(95%CI:17-25%),健康对照者为10%(95%CI:5-18%)(p=0.30)。在血清阳性的复发性腹痛儿童中,通过培养和组织学检查发现66例中有46例存在幽门螺杆菌。幽门螺杆菌的存在与活动性或非活动性慢性胃炎显著相关。幽门螺杆菌的存在与父母双方均出生在幽门螺杆菌高流行国家且社会阶层较低有关。幽门螺杆菌阳性儿童比幽门螺杆菌阴性儿童更常出现与进餐相关的疼痛。两组在血红蛋白、白细胞、血小板、体重和身高水平方面未见差异。总之,复发性腹痛儿童与健康儿童的幽门螺杆菌血清阳性率相当。幽门螺杆菌阳性的复发性腹痛儿童未出现特定症状。

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