Clinical Study On The Relationship Between Different Types Of Helicobacter Pylori Infection And Gastroduodenal Diseases In Children

Objective:To compare the detection rates of different types of Helicobacter pylori in children with gastroduodenitis and peptic ulcer,and to explore the relationship between the types of Helicobacter pylori infection and children's gastroduodenal diseases.At the same time,the subjects were given standard triple therapy and treated with 14-day Hp eradication regimen,so as to compare the 14-day Hp eradication rates of different types of Helicobacter pylori infection-related gastroduodenitis and peptic ulcer,and to clarify the impact of different types of Helicobacter pylori infection on the standard triple therapy for Hp eradication.Method:123 children with ¹³C-urea breath test(¹³C-urea breath test,¹³C-UBT)positive and gastroscopic examination were selected from July 2017 to July 2018.In addition,serum cytotoxin associated protein A?CagA?and vacuolating cytotoxins A?vacuolating cytotoxins A,VacA?antibodies were detected by enzyme-linked immunosorbent assay?ELISA?in 123 children.According to the results of serum examination,we can determine indirectly the expression of serum VacA and CagA in children,and then the Hp strains can be divided into type?strain?VacA and CagA are both positive?and type?strain?VacA and CagA are both negative?.At the same time,according to the results of gastroscopy,the subjects were divided into group A:gastric and duodenal ulcer group,group B:gastric and duodenitis group,and the detection rates of CagA and VacA antibodies were compared between the two groups.All subjects were given standard triple therapy?amoxicillin+clarithromycin+omeprazole for 14 days?for Hp eradication.After 4 weeks of treatment,¹³C-UBT was reexamined to analyze the relationship between the eradication rate of Hp and the distribution of serum antibodies under standard triple therapy.Result:The detection rates of type I bacteria were 68.75%and 27.91%in gastric and duodenal ulcer group?group A?and gastric and duodenitis group?group B?,respectively.It can be seen that the detection rate of type I bacteria was higher in group A;The detection rates of type II strains were 18.75%and 51.16%in children with gastric and duodenal ulcer group?group A?and gastric and duodenitis group?group B?,respectively.The detection rates of type II strains were higher in children with gastric and duodenal ulcer?group B?.The significant differences in the detection rates of type I and type II strains between the two groups have statistical significance?P<0.05?.After standard triple therapy,the eradication rates of Hp in children with gastroduodenitis and gastritis associated with Hp infection were 90%and 50%respectively in 14 days.The difference is statistically significant in eradication rate of type I and type II strains in 14 days of gastroduodenitis associated with Hp infection?P<0.05?;In children with gastric and duodenal ulcers associated with Hp infection,the eradication rates of Hp infection,were 89.36%and64.29%respectively in 14 days.The difference is statistically significant in 14-day eradication rates of strains I and II in gastric and duodenal ulcers associated with Hp infection?P<0.05?;The total eradication rates of type I and type II strains in 14 days of Hp infection-related diseases were 89.47%and 56.25%respectively.The difference between the two groups is statistically significant.?P<0.05?.Conclusion:1?The type of Hp strain is related to the type of gastric and duodenal diseases in children,but this can not be used as the only factor to distinguish the different gastric and duodenal diseases caused by Hp infection.2?In different types of Helicobacter pylori infection-related upper gastrointestinal diseases,there is significant difference in the efficacy of standard triple therapy.