高利伟 刘鸿 赵长安

[摘要] 目的 探讨幽门螺杆菌（Hp）感染与不同年龄段儿童上消化道黏膜病变的致病性及对儿童血红蛋白值产生的影响。 方法 收集2014年7月～2015年6月在研究医院内镜中心行胃镜检查，诊断为慢性浅表性胃炎或上消化道溃疡病例246例，根据胃镜和Hp检查结果将其分为3组：Hp阴性慢性浅表性胃炎组（A组）65例，Hp阳性慢性浅表性胃炎组（B组）154例，Hp阳性上消化道溃疡组（C组）27例，75例Hp阴性健康儿童作为对照组，比较各组儿童血红蛋白值和红细胞计数以及不同年龄段患儿Hp感染情况。 结果 ①研究组患儿Hp总阳性率为73.58%，在<3岁、3岁～、6岁～、10～17岁年龄段中Hp阳性率分别为70.83%、71.19%、72.63%、77.94%，Hp阳性慢性浅表性胃炎的发生率分别为50.00%、61.02%、66.32%、63.24%，Hp阳性上消化道溃疡的发生率分别为20.83%、10.17%、6.32%、14.71%，各年龄段比较差异无统计学意义（P均>0.05）。②C组患儿血红蛋白值[（103.52±28.27）g/L]明显低于A组[（125.85±11.42）g/L]、B组[（127.82±11.94）g/L]和对照组[（127.41±8.79）g/L]，差异有统计学意义（P均<0.05）；A组、B组和对照组儿童的血红蛋白值两两比较，差异无统计学意义（P均>0.05）。 结论 Hp感染对儿童上消化道黏膜的致病性与年龄无关，Hp感染对儿童血红蛋白值的影响与其所引起的上消化道黏膜病变严重程度密切相关。

[关键词] 幽门螺杆菌；儿童；血红蛋白；胃炎

[中图分类号] R573 [文献标识码] A [文章编号] 1674-4721（2016）03（b）-0092-04

[Abstract] Objective To explore the influence of Helicobacter pylori（Hp） infection，chronic superficial gastritis，and upper digestive tract ulcer on the value of children′s hemoglobin with different ages. Methods 246 patients who were performed with gastroscopy in endoscope center in our hospital and diagnosed as chronic superficial gastritis and upper digestive tract ulcer from July 2014 to June 2015 were collected.According to endoscopic and Hp examination outcomes，they were divided into 3 groups：Hp negative plus chronic superficial gastritis group（group A，n=65），Hp positive plus chronic superficial gastritis（group B，n=154），and Hp positive plus upper digestive tract ulcer（group C，n=27）.Another group of 75 healthy children without Hp infection was classified into control group.The children′s hemoglobin value，red blood cell count，and Hp infection at different ages in the research group were compared. Results In the research group，the total Hp positive rate was 73.58%.The Hp positive rate at less than 3 years old，3 to 6 years old，6 to 10 years old，and 10 to 17 years old was 70.83%，71.19%，72.63% and 77.94% in turn.The incidence of Hp positive plus chronic superficial gastritis among these 4 groups was 50.00%，61.02%，66.32%，and 63.24% accordingly.The incidence of Hp positive plus upper digestive tract ulcer was 20.83%，10.17%，6.32%，and 14.71% respectively，which was not displayed stastical difference（all P>0.05）.In group C，the value of hemoglobin was （103.52±28.27）g/L，much lower than （125.85±11.42）g/L in group A，（127.82±11.94）g/L in group B，and （127.41±8.79）g/L in control group，which was displayed a statistical difference amont each group（all P<0.05）.The value of hemoglobin in group A or group B was not in a statistical difference after comparison with that in control group （both P>0.05）. Conclusion Upper digestive tract mucosa pathogenicity due to Hp infection is not related with age.Influence of hemoglobin value in children by Hp infection is closely related with the severity of upper digestive tract mucosa lesions caused by Hp infection.

[Key words] Helicobacter pylori；Children；Hemoglobin；Gastritis

幽门螺杆菌（Helicobacter pylori，Hp）自被发现以来，其与慢性胃炎和消化性溃疡的关系已越来越明确，被列为消化系统疾病的首要致病因子[1]。Hp感染也是儿童消化性溃疡的主要病因，并与儿童慢性胃炎、消化不良等密切相关[2]。Hp感染还可能参与某些胃肠外的疾病，如心血管系统、神经系统、血液系统、皮肤系统等，但结果仍有争议，值得进一步探讨[3]。Hp感染对儿童铁吸收及对血红蛋白的影响也存在争议，有研究认为，Hp感染与儿童缺铁性贫血存在相关性[4]，无症状Hp感染是造成或加重儿童机体铁营养不良的原因[5]。也……