Bansal D, Patwari A K, Malhotra V L, Malhotra V, Anand V K
Department of Pediatrics and Microbiology, Lady Hardinge Medical College, New Delhi.
Indian Pediatr. 1998 Apr;35(4):329-35.
To study the relationship between Helicobacter pylori (Hp) infection and recurrent abdominal pain (RAP) and to evaluate various modalities to diagnose Hp infection.
Prospective case control study.
Teaching hospital.
Children between 3-12 years of age with RAP in whom upper gastrointestinal endoscopic examination was indicated were studied. Endoscopic biopsy specimen were collected from duodenum, antrum and esophagus. Apart from histopathological examination of biopsy material, rapid urease test (RUT) of the antral biopsy specimen and blood examination to estimate specific IgG antibodies to Hp by Indirect Solid Phase Enzyme Immunoassay was performed. The results of Hp IgG antibodies was compared with age matched controls.
Thirty one children with RAP were subjected to endoscopic examination and their anti Hp IgG antibodies status compared with 26 controls. Hp colonization was detected in 7 children (23%) with RAP; by RUT in 23% and antral biopsy in 16% of cases. Anti Hp IgG antibodies were also positive in almost equal proportion (19%) of controls (p = 0.757). Endoscopic examination revealed esophagitis in 16% of cases and none had evidence of gastric or duodenal erosion, ulcer or cobblestone appearance of antrum. A significant correlation of Hp was noticed with chronic antral gastritis (p = 0.002), chronic duodenitis (p = 0.02) and age > 10 years (p = 0.02). No significant correlation was noticed between Hp colonization and various socioeconomic risk factors.
Hp does not seem to be commonly associated with RAP in our patient population as Hp colonization was detected in only 23% of cases which was not significantly higher than the seroprevalence of anti Hp IgG antibodies in the controls. However, a small sample size of our study limits drawing any firm conclusions. Antral gastritis and chronic duodenitis had a significant correlation with Hp colonization. RUT was found to be a reliable diagnostic test to detect Hp.
研究幽门螺杆菌（Hp）感染与复发性腹痛（RAP）之间的关系，并评估诊断Hp感染的各种方法。
前瞻性病例对照研究。
教学医院。
对3至12岁有RAP且需进行上消化道内镜检查的儿童进行研究。从十二指肠、胃窦和食管采集内镜活检标本。除了对活检材料进行组织病理学检查外，还对胃窦活检标本进行快速尿素酶试验（RUT），并通过间接固相酶免疫测定法进行血液检查以估计针对Hp的特异性IgG抗体。将Hp IgG抗体的结果与年龄匹配的对照组进行比较。
31例有RAP的儿童接受了内镜检查，并将他们的抗Hp IgG抗体状态与26例对照组进行比较。在7例（23%）有RAP的儿童中检测到Hp定植；通过RUT检测到的比例为23%，通过胃窦活检检测到的比例为16%。对照组中抗Hp IgG抗体呈阳性的比例几乎相同（19%）（p = 0.757）。内镜检查显示16%的病例有食管炎，且无一例有胃或十二指肠糜烂、溃疡或胃窦鹅卵石样外观的证据。发现Hp与慢性胃窦炎（p = 0.002）、慢性十二指肠炎（p = 0.02）以及年龄＞10岁（p = 0.02）有显著相关性。未发现Hp定植与各种社会经济风险因素之间有显著相关性。
在我们的患者群体中，Hp似乎与RAP并不常见相关，因为仅在23%的病例中检测到Hp定植，这并不显著高于对照组中抗Hp IgG抗体的血清流行率。然而，我们研究的样本量较小，限制了得出任何确凿结论。胃窦炎和慢性十二指肠炎与Hp定植有显著相关性。发现RUT是检测Hp的可靠诊断试验。
