消化系统疾病

003477应用血清学及13G一尿素呼吸试验对幽门螺杆菌家庭感染状况的研究在页立…//中国当代儿科杂志一2000,2(1)一27一29 对166例反复慢性腹痛患儿研究结果显示一级亲属有幽门螺杆菌(HP)带菌的家庭中儿童HP症状性感染率高,HP感染有明显的家庭聚集性。血清Hl〕一IgG检测敏感性好,特异性差,‘”C一尿素呼吸试验比血清学检测更能反应HP家庭实时感染状况。表3参4(张家栋) 003478 1 442例儿童幽门螺杆菌感染状况及相关性疾病分析月余晓华一//中华流行病学杂志一2000,21(2)一100一102 1 442例中血清抗幽门螺杆菌(抗HP-馆G)( )615例,随年龄增…     

儿童消化系统症状与幽门螺杆菌感染之间关系分析

目的研究儿童幽门螺杆菌(HP)感染后消化系统症状发生的相关性。方法对上海市某区430名4～16岁儿童进行了一次整群抽样调查,内容包括血清HP抗体检测及详细记录儿童消化系统症状,血清HP抗体阳性儿童同时进行粪HP抗原测定,有消化系统症状患儿尽可能作胃镜检查。结果430名中HP感染阳性儿童121例,感染率为28.1%,学龄前(4～6岁)、学龄期(7～12岁)、青春期(13～16岁)三个年龄阶段HP感染率分别为19%、30%、47%,HP感染阳性有消化道症状儿童90例,占HP感染阳性儿童(62名)74%,HP感染阴性有消化道症状儿童77名,占HP感染阴性儿童(258名)30%,二者在统计学上有显著差异。且以腹痛、厌食最为常见。行胃镜检查的患儿共33人,HP感染阳性27人,HP感染阴性6人,患慢性胃炎、十二指肠炎、胃溃疡、十二指肠溃疡的儿童30人,疾病检出率为90%。结论(1)HP感染在儿童中有很高的感染率,随着年龄的增长,感染率增加。(2)HP感染可以引起儿童一系列消化道症状,年龄小,症状不典型,随着年龄增长,消化道症状发病率增高,胃镜检查有较高的疾病检出率。     

应用血清学及13C-尿素呼吸试验对幽门螺杆菌家庭感染状况的研究

目的　研究一级亲属幽门螺杆菌 (helicobacterpylori,HP)感染状况以及其对儿童HP感染的影响。方法　应用血清学及13 C -尿素呼吸试验 (13 C -ureabreathtest,13 　C -UBT)测定反复腹痛儿童及父母的HP感染情况。结果　13 C -UBT及血清HP -IgG测定家庭的HP感染率分别为 41 .6 %和 76 .5 % ,显著高于腹痛儿童的HP感染率 2 9.5 %和 5 4.8% (P <0 .0 5和P <0 .0 0 5 )。儿童13 C -UBT及血清学阳性时 ,其家庭HP感染率分别为83.7%和 85 .7% ,显著高于其儿童阴性时的家庭HP感染率 2 3.9%和 6 5 .3% ;家庭13 C -UBT及血清学阳性时 ,其儿童HP感染率分别为 5 9.4%和 6 1 .4% ,也显著高于其家庭阴性的儿童HP感染率 8.3%和 33.3% ,P <0 .0 0 5。血清学检查的敏感性为 94.2 % ,特异性 36 .1 %。结论　一级亲属有HP带菌的家庭中儿童HP症状性感染率高 ,HP感染有明显的家庭聚集性。血清HP -IgG检测敏感性好 ,特异性差 ,13 C -UBT比血清学检测更能反应HP家庭实时感染状况。     

应用血清学及13C-尿素呼吸试验对幽门螺杆菌家庭感染状况的研究

目的　研究一级亲属幽门螺杆菌 (helicobacterpylori,HP)感染状况以及其对儿童HP感染的影响。方法　应用血清学及13 C -尿素呼吸试验 (13 C -ureabreathtest,13 　C -UBT)测定反复腹痛儿童及父母的HP感染情况。结果　13 C -UBT及血清HP -IgG测定家庭的HP感染率分别为 41 .6 %和 76 .5 % ,显著高于腹痛儿童的HP感染率 2 9.5 %和 5 4.8% (P <0 .0 5和P <0 .0 0 5 )。儿童13 C -UBT及血清学阳性时 ,其家庭HP感染率分别为83.7%和 85 .7% ,显著高于其儿童阴性时的家庭HP感染率 2 3.9%和 6 5 .3% ;家庭13 C -UBT及血清学阳性时 ,其儿童HP感染率分别为 5 9.4%和 6 1 .4% ,也显著高于其家庭阴性的儿童HP感染率 8.3%和 33.3% ,P <0 .0 0 5。血清学检查的敏感性为 94.2 % ,特异性 36 .1 %。结论　一级亲属有HP带菌的家庭中儿童HP症状性感染率高 ,HP感染有明显的家庭聚集性。血清HP -IgG检测敏感性好 ,特异性差 ,13 C -UBT比血清学检测更能反应HP家庭实时感染状况。     

昆明地区儿童幽门螺杆菌感染状况及危险因素分析

目的了解和探讨昆明地区儿童幽门螺杆菌感染状况及其危险因素。方法随机抽取2008年1月至2010年6月在儿科就诊无消化道症状并做血清H.pylori抗体检测的儿童进行问卷调查。通过单因素配对资料χ2分析及多因素logistic回归分析,筛选出危险因素。结果共478例儿童中H.pylori IgG阳性238例,感染率为49.8%。其中1～3岁、4～7岁、8～14岁H.pylori IgG阳性率分别为24.3%、42.4%、58.3%。学龄期儿童(>7岁)占总感染人数的64.7%。而年龄、共用牙刷口杯、共用餐具、家庭人口数多、经济收入低、人均居住面积小及父母亲和照顾者有胃病史等为H.pylori感染的危险因素。结论 H.pylori感染在儿童中,尤其学龄儿童较为常见,与年龄相关。H.pylori感染危险因素的筛查为预防提供指导。     

幽门螺杆菌在儿童特发性血小板减少性紫癜的感染状况分析

目的探讨特发性血小板减少性紫癜(ITP)患儿幽门螺杆菌(Hp)感染状况及相关危险因素。方法用粪便检测Hp抗原及血清检测Hp抗体两者联合检测62例慢性ITP患者,88例急性ITP患者及150例健康儿童,两者均为阳性判断为Hp感染。对每个研究对象进行问卷调查。结果急、慢性ITP患儿、健康儿童三者感染率比较无统计学意义(P<0.05)。HP感染家族史、口嚼食物喂养史、啃手指/笔/玩具、低人均居住面积为ITP患儿Hp感染的易感因素;年龄小、有专用餐具为ITP患儿Hp感染的保护因素。结论本研究不表明Hp感染与ITP发病相关。     

荧光PCR和定量ELISA在呼吸道肺炎支原体感染诊断中的应用

目的 探讨定量ELISA和荧光PCR方法在呼吸道肺炎支原体(MP)感染中的临床应用和意义.方法 选取于2006年1月-2008年12月因急性呼吸道感染住院治疗的患儿3 958例,进行多种病原联合检测.应用定量ELISA和荧光PCR检测血清特异性抗体和痰液特异性核苷酸序列,明确MP感染;同时检测151例患儿家属血清MP特异性抗体.结果 PCR检测阳性率为8.9%;单份血清ELISA检测阳性率为23.24%,双份血清的阳性率为37.18%;PCR与EUSA联合检测阳性率为31.07%.血清ELISA阳性率显著高于痰PCR-DNA阳性率,PCR和ELISA的一致性较差.MP感染阳性率随年龄的增长而增加.不同疾病MP感染阳性率也不同,毛细支气管炎最低(9.04%),大叶性肺炎患儿MP感染阳性率高达72.55%.MP感染与肺炎衣原体感染存在正相关,而与RSV感染存在负相关.患儿和家属之间存在交叉感染.结论 MP是儿童呼吸道感染的主要病原体之一.定量ELISA和荧光PCR均适合临床应用,联合应用有利于作出早期诊断、进行合理治疗.     

~(13)C呼吸试验对儿童幽门螺杆菌感染的诊断价值

目的　应用胃镜检查及血清抗幽门螺杆菌抗体 (HP IgG)的检测结果对比13 C尿素呼吸试验 (13 C UBT) ,评价13 C UBT对儿童幽门螺杆菌 (HP)感染的诊断可靠性。方法　 1997年 10月～ 1999年 12月我院消化门诊具有反复中上腹痛、脐周痛等上消化道症状的患儿 5 89例 ,年龄 4～ 14岁、平均9岁 ;其中 435例进行13 C UBT检查 ,检测当日早晨空腹口服一杯麦片饮食延缓胃排空 ,接着口服 5 0mg13 C 尿素试剂 ,于服药前及服药后半小时取气样 ,应用同位素比值质谱仪检测 ,以DOB表示。检查前停服抗生素 2周者 2 47例 ,停服 4周者 188例。 41例症状严重的患儿同时做胃镜 ,取胃窦粘膜行嗜银染色检查及快速尿素酶试验 ,两者均阳性者确定为HP感染。对比计算13 C UBT检测结果与胃镜检查的符合率、敏感性、特异性、阳性预测值、阴性预测值。同期有 30 0例患儿行血清HP IgG测定 ,其中146例测定了13 C UBT ,观察与HP IgG的符合率。结果　13 C UBT阳性率 2 7 5 8%,随年龄增长感染率上升 ,7岁以后上升明显 ,儿童期感染率剧增 ,符合发展中国家的类型。检查前停服抗生素 2周与 4周者阳性率分别为 2 7 12 %、2 8 19%。血清抗HP IgG阳性率 5 6 7%。胃镜检查阳性率 39%,阳性染色切片中HP菌数量较少。13 C UBT与胃镜检查的符合率为 90     

^13C呼吸试验对儿童幽门螺杆菌感染的诊断价值

目的 应用胃镜检查及血清抗幽门螺杆菌抗体（HP－IgG)的检测结果对比^13C尿素呼吸试验（^13C-UBT),评价^13C-UBT对儿童幽门螺杆菌（HP）感染的诊断可靠性。方法 1997年10月－1999年12月我院消化门诊具有反复中上腹痛、脐周痛等上消化道症状的患儿589例,年龄4－14岁、平均9岁;其中435例进行^13C-UBT检查,检测当日早晨空腹口服一杯麦片饮食延缓胃排空,接着口服50mg ^13C -尿素试剂,于服药前及服药后半小时取气样,应用同位素比值质谱仪检测,以DOB表示。检查前停服抗生素2周者247例,停服4周者188例。41例症状严重的患儿同时做胃镜,取胃窦粘膜行嗜银染色检查及快速尿素酶试验,两者均阳性者确定为HP感染。对比计算^13C-UBT检测结果与胃镜检查的符合率、敏感性、特异性、阳性预测值、阴性预测值。同期有300例患儿行血清HP－IgG测定,其中146例测定了^13C-UBT,观察与HP－IgG的符合率。结果 ^13C-UBT阳性率27．58％,随年龄增长感染率上升,7岁以后上升明显,儿童期感染率剧增,符合发展中国家的类型。检查前停服抗生素2周与4周者阳性率分别为27．12％、28．19％。血清抗HP－IgG阳性率56．7％。胃镜检查阳性率39％,阳性染色切片中HP菌数量较少。^13C-UBT与胃镜检查的符合率为90．24％,敏感性75％,特异性100％,阳性预测值100％,阴性预测值86．2％;^13C-UBT与血清HP－IgG符合率为63．01％。结论 ^13C-UBT有较高的敏感性和高度的特异性,作为非侵入性方法检测儿童HP感染是较可靠的。停服抗生素2周与停服4周^13C-UBT阳性率无差别。     

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目的探讨幽门螺杆菌(HP)感染对不同年龄组儿童慢性胃炎胃黏膜病理变化的影响。方法 2007年1月至2010年12月,对上海交通大学医学院附属瑞金医院1634例反复上消化道症状儿童行电子胃镜检查,取胃窦部黏膜组织检测HP,按1996年悉尼标准进行病理评分,分析HP感染与炎症严重程度及活动性的关系。并根据年龄分为4组:<4岁组69例,4～<7岁组313例,7～<11岁组706例,11～18岁组546例,比较各组HP感染率、活动性病变发生率以及淋巴滤泡检出率的差异。结果 1634例患儿中HP阳性524例(32.1%),阳性率随年龄增长而升高。HP阳性患儿活动性炎症、中重度炎症、中性粒细胞浸润、淋巴细胞重度浸润和淋巴滤泡的检出率均高于阴性者(P<0.01)。胃黏膜病理示慢性浅表性胃炎(CSG)中、重度炎症及慢性萎缩性胃炎(CAG)中度炎症的发生率,HP阳性患儿均高于阴性者(P<0.01)。除婴幼儿组外,各年龄组HP感染患儿的活动性病变发生率和淋巴滤泡检出率均显著高于HP阴性者(P<0.05)。结论儿童HP感染率随年龄增长而升高。HP感染与胃黏膜炎症严重程度、活动性炎症发生率以及滤泡样改变均密切相关,与慢性胃炎不同病理类型的严重程度也密切相关。     

有消化道症状儿童幽门螺旋杆菌现症感染的调查

目的：了解有消化道症状的儿童幽门螺杆菌（H. pylori）现症感染状态,并调查H. pylori感染的危险因素。方法：选择有上消化道症状的376例患儿进行胃镜检查,同时取3块胃黏膜分别作快速尿素酶及病理组织学检查。部分患儿行13C-尿素呼气试验。上述3种方法中2项或2项以上阳性者诊断为H. pylori感染。同时对患儿居住环境、家庭经济状况、父母文化程度、消化道疾病家族史进行问卷调查。结果：376例患儿中,H. pylori现症感染率为44.9%（169例）。男女H. pylori感染率差异无统计学意义（P>0.05）。3岁~、8岁~、13~16岁年龄组H. pylori阳性率分别为39.5%（47/119）、41.0%（55/134）、54.5% (67/123）,不同年龄组间患儿H. pylori感染率差异有统计学意义（χ2=6.76,P<0.05）。儿童全托及中小学生寄宿、集体居住及用餐者H. pylori阳性率高于非集体居住及用餐者（53.6% vs 40.6%, P<0.05）。家庭经济收入高者H. pylori阳性率低于中低收入者（36.9% vs 48.3%,P<0.05）。父母文化程度高者H. pylori阳性率低于父母文化程度较低者（39.5% vs 50.8%,P<0.05）。有胃炎或消化性溃疡病家族史者H. pylori感染率高于无家族史者（52.9% vs 41.2%,P<0.05）。结论：随着年龄的增长,H. pylori感染率逐渐增加。集体居住、共同用餐、家庭低收入、父母受教育程度低以及有上消化道疾病家族史的患儿有较高的H. pylori感染率,因此以上因素是儿童感染H. pylori的危险因素。     

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??Objective??To investigate the current rate of Helicobacter pylori infection in asymptomatic children residing in Beijing urban area and to discuss the risk factors that predispose children to such infection. Methods??A total of 1196 asymptomatic children aged from 1 month to 18 years were selected from urban schools in Beijing areas. A face to face interview was conducted with a specially designed standard questionnaire. We performed enzyme-linked immunoadsorbent assay ??ELISA?? for H.pylori stool antigen test to determine H.pylori infection status. Results??The overall prevalance of H.pylori was 10.6%. On univariate analysis??risk factors for H.pylori infection included age??poor hygienic habits??lower socioeconomic status??and positive family history of gastrointestinal diseases. Multivariate logitstic regression identified that age??poor hygienic habits??economic status??number of people in the same house??house area??and positive family history of gastrointestinal diseases were the independent risk factors of H.pylori infection. Conclusion??H.pylori infection rate among these children is high??and increases with age. H.pylori infection clusters within families and is closely associated with personal and familial hygienic habits.     

807例住院儿童弓形虫感染调查分析

目的：研究该院住院儿童弓形虫感染情况,探讨防治方法。方法：使用统一调查表问卷调查,同时采集静脉血807份,以ELISA法检测血清弓形虫IgG和IgM。结果：弓形虫IgG阳性率为3.28%,IgM为1.98%。除新生儿组外,婴儿组、幼儿组、学龄前期组、学龄期、青少年组弓形虫IgG,IgM阳性率随年龄递增而有升高趋势。有猫狗接触史组弓形虫IgG阳性率高于无猫狗接触组(6.01% vs2.40%),差异有显著性(P<0.05)。不吃羊肉串、火锅、切菜板生熟分开组弓形虫IgG阳性率2.79%,IgM阳性率1.06%,低于有不良饮食习惯组(9.43%,15.09%),两组比较差异有显著性意义(P<0.01)。结论：应加强健康教育,养成良好的生活习惯及饮食习惯,以减少弓形虫感染。     

Evaluation of association between hepatitis A and Helicobacter pylori infections and routes of transmission

Previous research about coexistence of Helicobacter pylori (HP) and hepatitis A virus (HAV) infections and the factors that increase their prevalence has suggested that the route of transmission of HP infection includes oral-oral and water-foods as well as the fecal-oral route. The aim of this study was to evaluate the routes of transmission of HP by comparing the seroprevalences of HP and HAV in children. One hundred and two children aged 1-18 years living in rural and urban regions of Izmir were included in this study. Anti-HP IgG and anti-HAV IgG antibodies were measured via enzyme immunoassay method. Seropositivities for HP and HAV were 56.8% and 51.9%, respectively. Seroprevalence for both infections increased with increasing age. However, a significant difference could not be detected between rural and urban areas. Sex did not have a significant effect. There was no infection in 22.1% of children, while 30.8% had both of the infections. 21.1% were positive only for HAV while 26% were positive only for HP. No significant correlation between seroprevalences of HP and HAV was detected. This study suggests the existence of various other routes of transmission of HP apart from the fecal-oral route.     

Uwarunkowania środowiskowe a stan odżywienia dzieci i młodzieży województwa podlaskiego

IntroductionChildren nutritional status results from both inherited genetic predispositions and environmental factors, such as biogeographic and social and economic ones.AimThe aim of the study was to evaluate the influence of environmental factors on children and adolescents nutritional status in the Podlasie Province.Material and methodsThe study was carried out on 592 children, aged 1–14, living in the urban and rural regions of the Podlasie Province. Questionnaires and anthropometric measurements with BMI were performed.ResultsBody mass deficit was observed in 24.2% of the examined children while overweight and obesity – in 12.5%. The highest percentage of body mass deficit (32.2%) was in the youngest children (1–3 years of age) and it decreased with the age. Body mass deifcit was also stated in families with lack of money for the rent (30.7%) and for food (32.5%). The percentage of children with overweight and obesity was comparable in all age groups and was approximately 12%. The lowest, 7.0%, was in large families.ConclusionsNutritional status of the examined children was conditioned by the family status, the number of children in the family and financial deficit. The highest percentage of under nutritional children was observed in families with lack of money for the rent and food.     

Long-lasting sensitization to food during the first two years precedes allergic airway disease

The purpose of the study was to investigate whether the duration of sensitization to food allergens during early childhood is related to later development of IgE mediated hypersensitivity to inhalant allergens and of allergic rhinitis and asthma in 5-year-old children and whether long-lasting food-sensitization may be used to predict subsequent allergic airway diseases. Five hundred and eight children of a prospective birth cohort study with available serum samples at one and two years of age were included and followed up until five years of age. Specific sensitization to food and inhalant allergens and the occurrence of subsequent allergic airway diseases were determined. Children with a long-lasting sensitization to food allergens (persistently sensitized for more than one year) produced significantly higher total IgE and specific IgE levels than children who were only transiently food-sensitized by two years of age. Children persistently sensitized to food had a 3.4 fold higher risk of developing allergic rhinitis and a 5.5 fold higher risk of developing asthma than infants who were only transiently food sensitized. Persistent food sensitization in combination with a positive atopic family history was a strong predictor for the development of allergic rhinitis and asthma at five years of age. The risks for these children are up to 50%, and 67% respectively. Persistently detectable sensitization to food over more than one year in early childhood is a strong prognostic factor for subsequent allergic airway disease. Persistently food-sensitized children especially in atopic families have to be regarded as a high-risk group and should be considered for preventive measures against respiratory atopy.     

无锡地区散居儿童幽门螺杆菌感染及相关因素流行病学调查

目的了解无锡地区儿童人群中幽门螺杆菌(H．pylori)感染率，探讨影响H．pylori感染的因素。方法采用酶联免疫分析法检测1126例0—12岁健康儿童及其父母粪便中的幽门螺杆菌抗原(HpSA)。并对每位人选者进行问卷调查，对其平时有无消化道症状、生活环境、生活习惯及家族史等情况进行了解。结果本地区儿童平均H．pylori感染率为19．1％，其中男性为19．6％，女性为18．5％，两者差异无显著性。有症状组阳性率为26．％，无症状组为10．6％。城区儿童H．pylori感染率为12．5％，城郊结合部儿童为19．3％，郊区、农村儿童为24．9％。结论无锡地区儿童中H．pylori感染率较高．有随年龄递增的趋势。幽门螺杆菌感染为引起无锡地区儿童胃十二指肠疾病的主要原因。     

Lower respiratory tract illness and RSV prophylaxis in very premature infants.

AIMS: To determine the frequency of and the risk factors for readmissions for any lower respiratory tract illness (LRTI) and for respiratory syncytial virus (RSV) documented LRTI in children born very prematurely who had or had not received RSV prophylaxis. METHODS: Multicentre prospective longitudinal cohort study of 2813 infants, born between April 2000 and December 2000 at less than 33 weeks of gestational age, and followed until the end of the epidemic season. RESULTS: Among the 2256 children who had no bronchopulmonary dysplasia at 36 weeks of postmenstrual age and were not submitted to RSV prophylaxis, 27.4% were readmitted at least once for any reason during the epidemic season; 15.1% and 7.2% were readmitted at least once for any LRTI and RSV related LRTI, respectively. Children born at less than 31 weeks' gestation, having an intrauterine growth restriction, or living in a single mother family were at a significantly higher risk of readmission for LRTI in general as well as for RSV related LRTI. Of the 376 children submitted to prophylaxis, 28.2% were readmitted at least once for any LRTI and 6.1% for RSV related LRTI. CONCLUSION: One out of four children who had received no prophylaxis, was born very prematurely, and was without bronchopulmonary dysplasia at 36 weeks of postmenstrual age, was readmitted at least once for any reason. Roughly 50% and 20% of these readmissions were related to a LRTI and an RSV infection, respectively. Further epidemiological studies are warranted to assess the aetiology and impact of other respiratory pathogens on post-discharge readmission and respiratory morbidity in this population.