摘要：
目的 探讨幽门螺杆菌(Helicobacter pylori,H.pylori)分型检测在儿童再发性腹痛(recurrent abdominal pain,RAP)诊治中的应用价值.方法 随机选择140例因RAP于本院就诊,高度怀疑胃炎的儿童作为实验组,另随机选择140例同期健康体检儿童作为对照组,均行13C-尿素呼气试验(13C-UBT),H.pylori阳性率分别为P1、P2.实验组H.pylori(+)者进一步行血清分型检测(Ⅰ型、Ⅱ型、中间型),同时完善胃镜检查,根据胃镜下胃粘膜病变程度分为轻度炎症组、中度炎症组、重度炎症组;Ⅰ型、中间型H.pylori感染儿童均给予标准三联疗法10d,停药4周后复查13C-UBT,对比二者H.pylori根除率,分别为P3、P4.结果 P1＞P2,P4＞ P3,差异具有统计学意义(均P＜ 0.05);Ⅰ型与重度胃炎有关,Ⅱ型与轻度胃炎有关,中间型与中度胃炎有关.结论 RAP与H.pylori感染关系密切,H.pylori血清分型检测有助于初步了解H.pylori(+)RAP儿童胃粘膜病变程度,为进一步胃镜检查提供指导,此外,针对不同分型的H.pylori采取不同的治疗方案或许能有效缓解RAP儿童的腹痛症状.%Objective To explore the value of applying helicobacter pylori typing in the diagnosis and treatment of children with recurrent abdominal pain (RAP).Methods 140 children with RAP and highly suspicious of gastritis were selected as an experimental group,and 140 children taking physical examination at the same time as a control group,13C-UBT were performed in both groups,and their H.pylori positive rates were represented with P1 and P2.The children with H.pylori (+) in the experimental group took serotyping detection (type Ⅰ,type Ⅱ,and middle type),and were performed gastroscopy at the same time;according to the degree of gastric mucosal lesions under gastroscope they were divided into a mild inflammation group,a moderate inflammation group,and a severe inflammation group.The children who had type Ⅰ or middle type H.pylori infection were given standard triple therapy for 10 days;and after 4 weeks' therapy they were rechecked by 13C-UBT,and their eradication rates were represented by P3 and P4,respectively.Results P1 ＞ P2 and P4 ＞ P3;there were statistical differences (P ＜ 0.05).Type Ⅰ was associated with severe gastritis,type Ⅱ with mild gastritis,and middle type with moderate gastritis.Conclusion RAP is closely related to H.pylori infection;helicobacter pylori typing can help preliminarily understand the degree of gastric mucosal lesions in children with with RAP,and provide guidance for further gastroscopy.In addition,different treatment regimens for different types of H.pylori may significantly alleviate the abdominal pain of RAP children.
