小儿消化性疾病的胃电图变化及与临床特点和胃镜特征的关联性

目的:分析小儿消化性疾病的胃电图变化及与临床病理特征和胃镜特征的关联性。方法:选取2018年1月至2019年5月我院儿科收治的经胃镜和病理学两种方式诊断为消化性疾病的患儿54例为观察组,另选取无胃肠道疾病的健康儿童40例为对照组。比较两组胃电图参数(频率均值和波幅均值),54例胃电图诊断后纤维胃镜检查结果,分析消化性疾病患儿HP感染与临床病理特征、溃疡面积的关系。结果:各组胃病患者胃电慢波频率均值各不相同(P0.05),三组患者胃电慢波波幅均值相比差异具有统计学意义(P0.05);且浅表性胃炎组、胆汁反流性胃炎组患者胃电慢波频率均值、胃电慢波波幅均显著低于胃溃疡组(P0.05);浅表性胃炎组患者胃电慢波频率均值显著低于胆汁反流性胃炎组(P0.05)。胆汁反流性胃炎组患者胃电慢波波幅显著低于浅表性胃炎组(P0.05)。胃镜检查结果显示,其中浅表性胃炎的诊断符合率较高,达90.00%,胃溃疡符合率为60.71%,胆汁反流性胃炎符合率为83.33%。HP检测结果显示,HP阳性患儿占总例数的77.78%(42/54),HP阴性患儿占总例数的22.22%(12/54);HP阳性组患儿淋巴滤泡形成、胃黏膜萎缩、胃黏膜炎性活动的发生率明显高于HP阴性组,差异具有统计学意义(P0.01);HP阳性组溃疡范围2 cm的患儿比例明显高于HP阴性患儿,差异具有统计学意义(P0.01)。结论:小儿消化性疾病胃电图存在餐后NSWP的下降及节律过缓的上升,胃电图检查和胃镜检查在诊断上有较高的符合率,HP感染科引起胃黏膜组织学改变,可作为小儿消化性疾病的靶向治疗。

Changes of Electrogastrogram in Children with Peptic Ulcer and Its Correlation with Clinical and Endoscopic Features

ABSTRACT Objective: To analyze the changes of electrogastrogram in children with peptic gastric ulcer and its correlation with clinicopathological and gastroscopic features. Methods: 54 children with peptic ulcer diagnosed by gastroscopy and pathology in our pediatrics department from January 2018 to May 2019 were selected as observation group, and 40 healthy children without gastrointestinal diseases were selected as control group. The parameters of electrogastrogram (mean frequency and mean amplitude) and the results of fiberoptic gastroscopy in 48 children with peptic ulcer were compared. The relationship between HP infection and clinicopathological features and ulcer area was analyzed. Results: The mean frequencies of gastric slow wave were different in each group (P < 0.05), and the mean amplitudes of gastric slow wave in the three groups were significantly different (P<0.05). The mean frequency and the mean amplitude of gastric electrical slow wave were significantly lower in the superficial gastritis group and the bile reflux gastritis group than in the gastric ulcer group (P<0.05). The mean frequency of gastric electrical slow wave in the superficial gastritis group was significantly lower than that in the bile reflux gastritis group (P<0.05). The amplitude of gastric electrical slow wave was significantly lower in the bile reflux gastritis group than in the superficial gastritis group (P<0.05). The results of gastroscopy showed that the diagnostic coincidence rate of superficial gastritis was 90.00 %, gastric ulcer was 60.71 %, and bile reflux gastritis was 83.33 %. The results of HP test showed that 77.78 % (42/54) of the total cases were HP-positive and 22.22 % (12/54) were HP-negative. The incidence of lymphatic follicle formation, atrophy of gastric mucosa and inflammatory activity of gastric mucosa in HP-positive group was significantly higher than that in HP-negative group (P<0.01), and the proportion of children with ulcer range > 2 cm in HP-positive group was significantly higher than that in HP-negative group (P<0.01). The difference was statistically significant (P< 0.01). Conclusion: Postprandial NSWP decrease and slow rhythm increase exist in electrogastrogram of peptic ulcer in children. The coincidence rate of electrogastrogram and gastroscopy in diagnosis is high. The histological changes of gastric mucosa caused by HP infection department can be used as targeted therapy for peptic ulcer in children.