儿童原发性十二指肠胃反流与幽门螺杆菌感染对胃炎和抗生素耐药性的影响

doi:10.7499/j.issn.1008-8830.2311086

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摘要目的探讨儿童原发性十二指肠胃反流（duodenogastric reflux, DGR）伴幽门螺杆菌（Helicobacter pylori, HP）感染发生的危险因素及对胃炎和抗生素耐药性的影响。方法回顾性分析2019年1月—2022年2月在无锡市儿童医院接受上消化道内镜检查的患儿的临床资料，308例经内镜诊断为原发性DGR，根据是否伴HP感染，分为原发性DGR伴HP感染组（53例）和不伴HP感染组（255例），分析影响原发性DGR伴HP感染发生的危险因素及其对胃炎发病率和严重程度的影响。331例HP感染患儿根据是否伴原发性DGR，分为HP感染伴原发性DGR组（29例）和不伴原发性DGR组（302例），分析原发性DGR伴HP感染对抗生素耐药性的影响。结果原发性DGR伴HP感染组患儿年龄高于不伴HP感染组（P<0.05），且两组患儿年龄分布差异有统计学意义（P<0.05）；两组患儿胃炎比例及胃炎严重程度比较差异无统计学意义（P>0.05）。多因素logistic回归分析显示，年龄大是原发性DGR伴HP感染发生的危险因素（P<0.05）。药敏试验显示HP感染伴原发性DGR组和不伴原发性DGR组甲硝唑、克拉霉素和左氧氟沙星的单一及联合耐药率比较差异无统计学意义（P>0.05）。结论年龄大与原发性DGR伴HP感染密切相关。原发性DGR伴HP感染对儿童胃炎和抗生素耐药性无显著影响。

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	王旭阳
	林琼

关键词 ：原发性十二指肠胃反流, 胃炎, 幽门螺杆菌, 耐药性, 儿童

Abstract：Objective To investigate the risk factors for Helicobacter pylori (HP) infection in children with primary duodenogastric reflux (DGR) and its impact on gastritis and antibiotic resistance. Methods A retrospective analysis was performed on the clinical data of 2 190 children who underwent upper gastrointestinal endoscopy in Wuxi Children's Hospital from January 2019 to February 2022, among whom 308 children were diagnosed with primary DGR. According to the presence or absence of HP infection, the children were classified to HP infection group (53 children) and non-HP infection group (255 children). The risk factors for HP infection and its impact on the incidence rate and severity of gastritis were analyzed. According to the presence or absence of primary DGR, 331 children with HP infection were classified to primary DGR group (29 children) and non-primary DGR group (302 children), and then the impact of primary DGR with HP infection on antibiotic resistance was analyzed. Results The HP infection group had a significantly higher age than the non-HP infection group (P<0.05), and there was a significant difference in the age distribution between the two groups (P<0.05), while there were no significant differences in the incidence rate and severity of gastritis between the two groups (P>0.05). The multivariate logistic regression analysis showed that older age was a risk factor for HP infection in children with DGR (P<0.05). Drug sensitivity test showed that there were no significant differences in the single and combined resistance rates of metronidazole, clarithromycin, and levofloxacin between the primary DGR group and the non-primary DGR group (P>0.05). Conclusions Older age is closely associated with HP infection in children with DGR. Primary DGR with HP infection has no significant impact on gastritis and antibiotic resistance in children.

Key words： Primary duodenogastric reflux Gastritis Helicobacter pylori Drug resistance Child

收稿日期: 2023-11-17

基金资助:无锡市卫生健康委妇幼健康科研项目（FYKY202108）。

通讯作者: 林琼，女，主任医师。Email：linqiong76@163.com。 E-mail: linqiong76@163.com

作者简介: 王旭阳，男，硕士研究生；

引用本文:

王旭阳,林琼. 儿童原发性十二指肠胃反流与幽门螺杆菌感染对胃炎和抗生素耐药性的影响[J]. 中国当代儿科杂志, 2024, 26(5): 493-498.

WANG Xu-Yang,LIN Qiong. Impact of primary duodenogastric reflux and Helicobacter pylori infection on gastritis and antibiotic resistance in children[J]. CJCP, 2024, 26(5): 493-498.

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