
幽门螺杆菌在小儿梅克尔憩室中的检出率及临床意义
Detection rate of Helicobacter pylori and its clinical significance in children with Meckel’s diverticulum
目的 探讨幽门螺杆菌(Hp)在梅克尔憩室(MD)患儿MD 组织中的检出率及临床意义。方法 应用免疫组织化学法检测45 例MD 并出血组和36 例MD 并非出血组患儿MD 组织和胃组织Hp 的检出率,比较其在两组组织中及不同临床特征出血患儿的MD 组织中的检出率差异。结果 出血组MD 组织Hp 阳性检出率76%(34/45)高于非出血组47%(17/36)(P<0.05);出血组胃组织Hp 阳性检出率[87%(39/45)] 与非出血组[67%(24/36)] 比较差异无统计学意义(P>0.05)。MD 并出血患儿MD 组织中Hp 检出率与患儿年龄、性别、术前出血次数、每次出血量、MD 长度、MD 基底直径和病理类型无关(均P>0.05),与MD 位置、是否伴有溃疡及溃疡深浅有关(均P<0.05)。Spearman 相关分析显示出血组患儿MD 组织与胃组织中Hp 阳性检出率呈显著正相关(P<0.05)。结论 Hp 在MD 并发出血患儿MD 组织中有较高的检出率,Hp 感染在MD 并出血患儿的出血过程中可能起一定作用。
Objective To determine the detection rate of Helicobacter pylori (Hp) in children with Meckel's diverticulum (MD) and its clinical significance among children with MD. Methods Eighty-one children with MD were divided into two groups according to the presence (n=45) or absence (n=36) of digestive hemorrhage. The detection rates of Hp in MD tissues and stomach tissues were determined by immunohistochemistry. The detection rates of Hp were compared between the two groups and between the MD tissues with different clinical features in the hemorrhage group. Results The detection rate of Hp in MD tissues for the hemorrhage group was 76% (34/45), which was significantly higher than that for the non-hemorrhage group (47%, 17/36) (P<0.05). The detection rate of Hp in stomach tissues for the hemorrhage group (87%, 39/45) was insignificantly higher than that for the non-hemorrhage group (67%, 24/36) (P>0.05). Among patients in the bleeding group, the detection rate of Hp in MD tissues showed no relationship with age, sex, preoperative hemorrhage frequency, amount of hemorrhage, length of MD, basal diameter of MD, and pathological type (P>0.05), but was related to location of MD, presence or absence of ulcer, and depth of ulcer (P<0.05). For the hemorrhage group, a significant positive correlation was found between the detection rates of Hp in MD tissues and stomach tissues (P<0.05), as shown by the Spearman correlation analysis. Conclusions The detection rate of Hp in MD tissues is increased in children with MD complicated by digestive hemorrhage. Hp infection may play some role in the hemorrhage process among children with MD.
幽门螺杆菌 / 梅克尔憩室 / 免疫组化 / 消化道出血 / 儿童
Helicobacter pylori / Meckel’s diverticulum / Immunohistochemistry / Digestive hemorrhage / Child
武汉市卫生局2011 年度临床医学科研项目(WX11D10)。