【摘要】 目的 探讨儿童慢性胃炎、胃十二指肠溃疡与血锌等微量元素变化的关系，以期为临床提供更可靠的诊疗指导。方法 选取门诊有上消化道症状的3～12 岁患儿，且经纤维胃镜确诊为慢性胃炎、胃十二指肠溃疡者30例。取空腹胃液2ml，经自动荧光分析仪检测Hp-DNA；用ELISA法测定血清Hp-IgG；用原子吸收法测定血锌、铜、铁、钙、镁元素。正常对照组20例，性别、年龄与患儿匹配。结果 30例患儿中，Hp+(幽门螺杆菌阳性)24例，占80%，其中浅表性胃炎14例中，Hp+10例(71.4%)；浅表胃炎并十二指肠炎5例中，Hp+4例(80%)；并十二指肠溃疡出血5例中，Hp+5例(100%)；胃溃疡出血并十二指肠炎6例中，Hp+5例(83.3%)。30例患儿中26例血锌下降，其中Hp+组尤为明显，与正常对照组差异有非常显著性(P<0.01)。结论 儿童慢性胃炎、胃十二指肠溃疡与Hp感染有明确的关系；且伴有血锌的下降。显示治疗中除常规抗Hp治疗外应补锌治疗，以改善免疫功能，提高治愈率，减少复发。

    【关键词】 儿童；消化性溃疡；幽门螺杆菌；锌；微量元素

    A study of the relationship between trace elements and chronic upper alimentary disease in children

    ZHANG Le-ling,WANG Su-lan,XU Jun-jie,et al.

    Jinan Children's Hospital,Jinan 250022,China

    【Abstract】 Objective To explore the relationship between chronic gastro-duodenal disorder and Hp infection,trace elements.Methods A total of 30 patients(aged 3～12ys) with chronic gastritis,gastro- and duodenal ulcer which were confirmed by endoscope were included in the study. 2 ml gastritis fluid was obtained in order to assess Hp-DNA by auto fluoroanalyzer,blood trace elements by atomic absorption spectroscopy. 20 control subjects matched on age and sex were also studied. Results Of 30 patients ,10 were 3～7 years old (33.3%). 20 were 8～12 years old (66.7%).24 patients (80%) showed Hp test positive. 10 out of 14 patients with superficial gastritis developed Hp+,while 4 of 5 patients with superficial gastritis plus duodenitis. All 5 patients with duodenal ulcer bleeding showed Hp+. This suggested that Hp positive in patients with duodenal ulcer was higher than that in patients with gastric ulcer. The blood zinc of 26 patients was decreased with significant differences comparing to normal group (P<0.01).Conclusion Our study showed definite relationships between Hp+ infection and chronic gastritis,gastric ulcer and duodenal ulcer.The Hp infection had positive correlation with age,that is the older the more opportunity to infect HP+. Decrease of blood zinc seems susceptible to HP+ infection. Thus it is necessary for us to treat the patients with zinc agents besides anti-HP+ routine procedures. ......