Parejo Carranza R, Olivares Miguel F, Escobar Castro H, Jiménez Alonso I, de Rafael Nerpell L, Camarero Salces C
Servicio de Pediatria y Microbiología, Hospital Ramón y Cajal, Madrid.
An Esp Pediatr. 1998 Sep;49(3):257-63.
The aim of this study was to investigate the usefulness of five diagnostic tests for Helicobacter pylori (Hp) infection in children.
Sixty-five children with epigastric pain, recurrent abdominal pain, regurgitation, diarrhoea, anemia and insulin-dependent diabetes mellitus were investigated. Endoscopic biopsies from gastric antrum were performed and examined by the urease rapid test, histological examination and microbiological culture. An ELISA was used to detect specific IgG and anti-Hp. A carbon urea breath test was performed in 58 patients.
Fifty-three patients were infected with Hp. The endoscopy appearance revealed nodularity in antral mucosa in 42 (79%) and erosions in 1 patient. The histology showed gastritis in all patients infected and Hp was identified in 46. The urease rapid test was positive in 96% and the culture positive in 89% of the patients infected. IgG antibodies to Hp were detected in 67% of the patients infected and the carbon urea breath test was positive in 96%. Twelve children were Hp negative, two of them having gastritis without Hp by histology. In the urease rapid test 3 false-positive results were detected and 1 false positive was found in the cultures. All Hp negative patients had negative results in the carbon urea breath test and were negative for IgG antibodies to Hp.
The carbon urea breath test has a high sensitivity and specificity for the diagnosis of Hp infection and allows the selection of candidates for endoscopy.
本研究旨在探讨五项诊断试验对儿童幽门螺杆菌（Hp）感染的诊断价值。
对65例有上腹部疼痛、反复腹痛、反流、腹泻、贫血及胰岛素依赖型糖尿病的儿童进行研究。取胃窦部内镜活检组织，进行尿素酶快速试验、组织学检查及微生物培养。采用酶联免疫吸附试验（ELISA）检测特异性IgG和抗Hp抗体。对58例患者进行了碳尿素呼气试验。
53例患者感染了Hp。内镜检查显示42例（79%）胃窦黏膜有结节，1例有糜烂。组织学检查显示所有感染患者均有胃炎，46例检出Hp。尿素酶快速试验在96%的感染患者中呈阳性，培养阳性率为89%。67%的感染患者检测到抗Hp IgG抗体，碳尿素呼气试验96%呈阳性。12例儿童Hp阴性，其中2例组织学检查显示有胃炎但无Hp感染。尿素酶快速试验检测到3例假阳性结果，培养中有1例假阳性。所有Hp阴性患者碳尿素呼气试验结果均为阴性，抗Hp IgG抗体也为阴性。
碳尿素呼气试验对Hp感染诊断具有较高的敏感性和特异性，可用于选择内镜检查的对象。
