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13碳尿素呼吸试验在诊断儿童幽门螺杆菌感染及评价疗效中的应用 |
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项立 朱松杰 张铮 唐沂
【摘要】 目的 探讨13 碳尿素呼吸试验(13C-UBT)在诊断儿童幽门螺杆菌（Hp）感染及评价疗效中的应用。方法 应用13C-UBT及血清 Hp-IgG检测193例无症状儿童及340例反复腹痛患儿Hp感染状况，将两项检测均为阳性的反复腹痛患儿88例随机分为治疗组(57例)和安慰剂组(31例)，接受奥美拉唑、克拉霉素、羟氨苄青霉素（阿莫西林）三联治疗，疗程 1 周。停药后 4 周随访。结果 腹痛患儿13C-UBT及Hp-IgG阳性率分别为29.1 %、 52.1 %,显著高于无症状儿(11.4 %、39.4 %)。2～、5～、10～14岁三组无症状患儿13C-UBT及Hp-IgG阳性率随年龄增加，但差异无显著性，P>0.05。三组患儿13C-UBT阳性率分别为29 %、29.1 %、30 %，与年龄无关，χ2=0.04 ,P>0.05；而Hp-IgG阳性率随年龄增加(36 %、53.7 %、70 %),差异有显著性，χ2=13.16,P<0.005。2～、5～10岁组 13 C-UBT及5～、10～14组 Hp-IgG阳性率，腹痛患儿较无症状儿明显增高。治疗后治疗组及安慰剂组腹痛消失或好转的总有效率分别为97%和26%; Hp根除率分别为88%,10%, 两组差异有显著性。结论 (1) 部分患儿反复腹痛与Hp感染密切相关，Hp感染随年龄增加，但症状性感染与年龄无关。(2) 13 C-UBT检测具有方法简单，准确性高，无损伤等优点，适用于儿童Hp感染诊断及根除的疗效判定。(3) 奥美拉唑等三联短程疗法治疗反复腹痛儿童Hp感染临床效果好，Hp根除率高，副作用少。
【关键词】 螺杆菌，幽门； 螺杆菌感染； 尿素酶； 奥美拉唑； 6-0-甲基红霉素； 阿莫西林
Usefulness of 13 C-urea breath test in the diagnosis of Helicobacter pylori infection and evaluation of Helicobacter pylori eradication in children
XIANG Li, ZHU Songjie, ZHANG Zheng
（Department of Pediatrics，Shenzhen People′s Hospital, Shenzhen 518020 , China）
【Abstract】 Objective To determine the usefulness of 13 C-urea breath test (13C-UBT) in the diagnosis of Helicobacter pylori (Hp) infection and evaluation of Hp eradication in children. Methods By using the 13 C-UBT and serum Hp-IgG antibody test, the authors detected the status of Hp infection in 193 asymptomatic children and 340 patients with recurrent abdominal pain (RAP). The patients who were identified to have Hp infection by both methods were divided into treatment group (57 cases) and placebo group (31) randomly. The treatment group were given a triple-therapy composed of omeprazole, clarithromycin, and amoxicillin for 1 week. They were followed-up and 13 C-UBT was repeated 4 weeks after the treatment was completed. Results The positive rates of 13 C-UBT and Hp-IgG antibody detection in children with RAP were 29.1 % and 52.1 %, respectively, which were much hi[1] [2] [3] 下一页
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