Text Box: ANALYSIS ON THE STATUS QUO OF HELICOBACTER PYLORI INFECTION AND ITS RELATED UPPER GASTROINTESTINAL DISEASES IN CHILDREN IN TIANJIN
Liu FL, Xu XH, Luo RC, Zheng LN,Zhang SH
Children's Hospital, Tianjin, China

Objective: The aim of this study is to investigate the status guo of Helicobacter pylori (Hp) infection in children in Tianjin and to study the relationship between the Hp infection and its related disease. 
Methods: During a five year period (1995,8~2000,12), Serological testing for Hp-IgG using ELISA was performed in 2857 children with different age who came from city or country of Tianjin. Of 526 children were surgical patients who were prepared operation without gastrointestinal diseases as an asymptomatic group. Of 2331 children with gastrointestinal complaint served as a symptomatic group and 1458 children of them had endoscopy. Endoscopic antral biopsies were obtain and analyzed for the presence of Hp using rapid urease testing (RUT), Giemsa staining for Hp. Hp infection was diagnosed by at least one criteria. 
Results: ①Of the 2857 children,1147 were Hp-IgG positive. The total positive rate was 40.15%. Positive rates of Hp-IgG among children under the age of 1 year, to3years, to6years, to10years and to 14years are 13.43%, 22.75%, 33.03%, 40.55% and 52.93%, respectively. ②Positive rates of Hp-IgG were 31.18% (164/526) and 42.17%(983/2331)in asymptomatic and in patients with gastrointestinal symptoms, which was significantly higher in the later group(p<0.005) ③The positive rate of Hp-IgG was different in children who came from city and from country,, they were 44.11% (592/1342) and 36.5% (555/1515), (P<0.005) .④The rate of Hp infection in patients with nodular gastritis and with duodenal ulcer (DU) was 96.48% (137/142) and 92.90% (157/169). Histological examination showed that Hp infection rates were 22.43%, 90.18% in mild and moderate or severe gastritis, respectively (p<0.005). 
Conclusions: ① The prevalence of Hp infection in children in Tianjin was high, which increased with age. ②The rate of Hp infection was higher in children with gastrointestinal symptoms than with asymptomatic. There was a high correlation between Hp infection and gastroduodenal disease in children especially in children with nodular gastritis and DU. Antral nodularity was an important specific endoscopic sign, unique to those children with Hp disease. ③The positive rate of Hp-IgG was greater in children who lived in city than in children who came from country , which suggests Hp infection is common among children living in relatively crowded conditions and indicates direct person-to-person transmission. Hp positive rate correlated with the pathohistologic severity of gastritis. 
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