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幽门螺杆菌阳性与幽门螺杆菌阴性的特发性消化性溃疡患儿长期转归的比较

Helicobacter pylori–positive Versus Helicobacter pylori–negative Idiopathic Peptic Ulcers in Children With Their Long-Term Outcomes

Tam YH, Lee KH, To KF 2010/4/21 16:31:23

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J Pediatr Gastroenterol Nutr, 2009,

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Objectives:
The aim of this study is to investigate the differences in the characteristics between Helicobacter pylori–positive and H pylori–negative primary ulcers in Chinese children.

Patients and Methods:
We conducted a retrospective review of children with primary peptic ulcers. Demographic data, clinical presentations, endoscopic features, histological findings, H pylori prevalence, and ulcer recurrences were studied.

Results:
Forty-three Chinese children with primary peptic ulcers were diagnosed over 8 years and were reviewed. There were 31 boys and 12 girls (median age 12 years, range 3–16 years). Thirty children (70%) presented with acute gastrointestinal bleeding, whereas only 19 had a history of epigastric pain. Twenty-three patients (53.5%) were H pylori positive. H pylori–positive ulcers developed in older children (median age 12 vs 10 years, P<0.05) and affected more males (91.3% vs 50%, P<0.01) than the H pylori–negative group. The annual ulcer recurrence rates were estimated to be 5.2% (95% CI 4.2–6.3) and 11.4% (95% CI 9.1–13.6) for positive and negative groups, respectively (P<0.05). Multivariate logistic regression suggested H pylori–negative status and ulcer size>1cm were indepen-dent risk factors for recurrence.

Conclusions:
Our report suggests that H pylori–negative primary ulcers exist in children with their own distinct features. In contrast to H pylori–positive ulcers, H pylori–negative ulcers develop in younger children, affect both sexes equally, and carry a higher recurrence risk.

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疾病资源中心

高血压	慢性阻塞性肺病
脂肪性肝病	糖尿病
卒中	肺癌
冠心病	子宫内膜异位症
结直肠癌	乳腺癌
心力衰竭	心律失常

病例分析 [栏目介绍]

甲状腺功能亢进合并黄疸

王燕燕王曙

上海交通大学附属瑞金医院内分泌科

患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。

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