- 期刊
Helicobacter Pylori Infection in Recurrent Abdominal Pain in Children -A Prospective Study
孩童慢性反覆腹痛與幽門螺旋菌相關這前瞻性研究
摘要
幽門螺旋菌好發於經濟與環境條件較差的地區。為了解孩童慢性反覆腹痛與幽門螺旋菌之相關性，我們一年內以前瞻性的方法，針對40位孩童作一系列的檢查。結果發現有7例(17.5%)，證實為幽門螺旋菌慢性胃炎。我們將病人分為兩組，一組為H. pylori陽性，另一組為H.pylori陰性。病理組織學方面，H.pylori陽性這一組皆有活動性慢性胃炎之組織學變化；而H.pylori陰性這一組，則大部分為輕微胃炎之胃黏膜病變。內視鏡學方面，感染幽門螺旋菌者，皆有慢性胃炎之外觀，其中胃竇部節結狀表徵佔43%。血清H. Pylori IgG測定，在H.pylori陽性組有71%呈現上升，而H.pylori陰性組只有15%(p=0.006)。血清H.pylori IgG定量的敏感性為71%，專一性為85%，而快速尿素試驗的敏感性與專一性各為86%、100%。胃竇部節結狀表徵是幽門螺旋菌慢性胃炎，在內視鏡檢查上一個很特殊且專一性的表徵。我們的研究顯示，雖然孩童之慢性腹痛病因中，幽門螺旋菌慢性胃炎可能失常其病因這一；但是，仍然沒有足夠的數據顯示兩者間有意義之關聯。所以，例行性的幽門螺旋菌感染之檢查，在慢性反覆腹痛病童中，仍然不被建議。
並列摘要
A total of 40 children was recruited to assess the role of Helicobacter pylori infection in children with recurrent abdominal pain syndrome. Among 40 children, seven (17.5%) cases were confirmed to have H. pylori infection. All H. pylori-positive patients had active chronic gastritis histologic findings (p＜0.001), however, the majority of the H. pylon-negative patients had minimal to mild gastritis histologic findings (p=0.001). Grossly, chronic gastritis picture was present in all children infected with H. pylori and antral nodular gastropathy present in 43%. 71% of H. pylori-positive patients had elevated anti-H. pylori IgG titer; however 15% in H. pylori-negative patients (p=0.006). Serum H. pylon assay had a sensitivity of 71% and specificity of 85%; however, sensitivity and specificity of rapid urease test were 86% and 100% respectively. Antral nodularity is a specific, peculiar endoscopic finding of children infected with H. pylon (p=0.004). Although the present study suggests that H. pylori-related chronic gastritis may play an etiological role in a subgroup of children with RAP syndrome, but the routine screening of H. pylori infection in children with RAP is not recommended, since no compelling data support the significant association between H. pylori infection and RAP syndrome.
延伸閱讀
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