Helicobacter Pylori Infection and Duodenal Ulcer in Children and Adolescents

爲了瞭解幽門螺旋杆菌感染與兒童及青少年慢性十二指潰瘍的關係，本研究對22名長期追踪的十二指腸潰瘍兒童(A組)檢查幽門螺旋杆菌之標記。另外36名有消化道症狀，接受上消化道內視鏡檢查，但無潰瘍者(B組)亦接受同樣檢查，以爲比較。胃竇及十二指腸組織切片取出之後，均施行尿素試驗，細菌培養及組織檢查。每個病人的血中幽門螺旋杆IgG抗體亦以酵素免疫法測定。以上述三法測定胃竇組織，結果A組幽門螺旋杆菌陽性率(68.2%-90.9%)較B組(16.7-17.1%)高出很多。但出十二指腸組織則無同樣情形。五個慢性十二指腸潰瘍手術後之患者中有四人爲幽門螺旋杆菌陽性。但此四人中，有一人因只接受十二指腸穿孔單純縫合，故十二指腸潰瘍再發；其他三人接受過迷走神經切除術者有慢性活動性胃炎，却無十二指腸潰瘍，顯示胃酸與十二指腸潰瘍發生亦有關係。總之，兒童及青少年的慢性十二指腸潰瘍及慢性活動性胃炎與幽門螺旋杆菌有很密切的關係，胃酸之角色亦不容忽略。

關鍵字

幽門螺旋桿菌；慢性十二指腸潰瘍；慢性活動性胃炎；尿素試驗

並列摘要

To investigate the relationship between H. pylon infection and duodenal ulcer in children and adolescents, the markers of H. pylon infection were studied in 22 children and adolescents who had duodenal ulcers and were followed prospectively (Group A). Another 36 patients with gastrointestinal symptoms, but without ulcer, were also studied for comparison (Group B). Antral and duodenal tissues were biopsied and analyzed for the presence of H. pylon using three standard methods: urease test, culture and histology. The specific IgG antibody against H. pylon positivity using the ELISA method were also analysed. By these three methods, H. pylon positivity in the antral tissues, chronic active antral gastritis, and seroprevalence rate were found to be much higher in Group A than Group B. However, a similar trend was not found in the duodenal tissues. H. pylon was found in four of five patients during postoperative follow-up for duodenal ulcer. Among the four patients, no duodenal ulcer but chronic active gastritis was detected endoscopically in three who received vagotomy. Only the one who received simple closure of the perforated duodenal ulcer had a recurrent duodenal ulcer. It was concluded that a close relationship among duodenal ulcer, chronic active gastritis and H. pylon is present in children and adolescents.

並列關鍵字

Helicobacter pylon ； duodenal ulcer ； chronic active gastritis ； urease test

國際替代計量

Helicobacter Pylori Infection and Duodenal Ulcer in Children and Adolescents

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