摘要目的 调查南京地区经胃镜检查儿童的幽门螺杆菌(Hp)感染情况.方法 选择南京医科大学附属南京儿童医院2001年1月至2010年12月行胃镜检查儿童2 990例,进行胃窦黏膜标本快速Hp尿素酶试验.结果 10年间2 990例患儿行胃镜检查,其中男性患儿1 718例,Hp感染检出率为53.8％(924/1 718例);女性患儿1 272例,Hp感染检出率为52.4％(667/1 272例),男女之间Hp感染检出率比较差异无统计学意义(x2＝0.532,P ＞0.05).2001年1月至2005年12月共检测611例儿童,Hp感染检出率为66.9％(409/611例),2006年1月至2010年12月共检测2 379例儿童,Hp感染检出率为49.7％(1 182/2 379例),差异有统计学意义(x2＝58.13,P=0.01).0～6岁359例,Hp感染检出率为49.6％(178/359例);＞6～9岁930例,Hp感染检出率为48.1％(447/930例);＞9～12岁1 089例,Hp感染检出率为55.2％(601/1 089例);＞12岁612例,Hp感染检出率为60.0％(365/612例),4组间Hp感染检出率比较差异有统计学意义(x2 =23.66,P＜0.01).消化道出血、上消化道症状、不明原因贫血及不明原因的脐周痛Hp感染检出率比较差异无统计学意义(x2=5.04,P ＞0.05).结节性胃炎Hp感染检出率高达61.4％,高于慢性浅表性胃炎Hp感染检出率(50.6％),差异有统计学意义(x2＝7.42,P＜0.01);过敏性紫癜Hp感染检出率为46.2％,高于胃镜正常儿童Hp感染检出率(15.9％),差异有统计学意义(x2=10.19,P＜0.01).结论 南京地区胃镜检查儿童Hp感染率有逐年下降趋势;6岁后Hp阳性率随年龄而稳定增长;Hp感染在儿童结节性胃炎和过敏性紫癜的发生中起一定作用.

abstractsObjective To investigate Helicobacter pyloric (Hp) infection in children who underwent gastroscopy in Nanjing area.Methods From Jan.2001 to Dec.2010,2 990 pediatric patients with gastrointestinal symptoms who underwent endoscopy and Hp rapid urease test of gastric mucosa specimens.Results There were 2 990 patients who underwent gastroscopy during the 10 years including 1 718 cases of male and 1 272 cases of female.The rate of Hp infection was 53.8％ (924/1 718 cases) and 52.4％ (667/1 272 cases) in male and female,respectively.There was no significant difference (x2 ＝ 0.532,P ＞ 0.05).From Jan.2001 to Dec.2005,611 patients were tested and the rate of Hp infection was 66.9％ (409/611 cases).From Jan.2006 to Dec.2010,2 379 patients were tested and the rate of Hp infection was 49.7％.There was significant difference(x2 =58.13,P =0.01) between the 2 groups.The rate of Hp infection were 49.6％,48.1％,55.2％,60.0％ in 0-6 years group,＞6-9 years group,＞9-12 years group,and ＞ 12 years group,respectively.There was significant difference among the 4 different age groups (x2 =23.66,P ＜ 0.01).The rate of Hp infection in nodular gastritis(61.4％) was higher than that in chronic superficial gastritis (50.6％).There was significant difference between the 2 groups (x2 ＝ 7.42,P ＜ 0.01).The rate of Hp infection in allergic purpura (46.2％) was higher compared with the children with normal gastroscopy results (15.9％).There was significant difference between the 2 groups (x2 =10.19,P ＜ 0.01).Conclusions There is gradually downward trend by year in the rate of Hp infection of children who underwent gastroscopy in Nanjing area by year.The rate of Hp infection is increasing with the age after the age of 6 years.Hp infection may play a role in the nodular gastritis and allergic purpura.