Avtor/Urednik		Logar-Car, Gordana; Gubina, Marija; Ferlan-Marolt, Vera
Naslov		Helicobacter pylori in nova terapevtska shema desetdnevnega zdravljenja simptomatskega kroničnega gastritisa pri otrocih
Prevedeni naslov		Helicobacter pylori and new therapeutic scheme of tendays treatment of symptomatic chronic gastritis at children
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 67, št. 12
Leto izdaje		1998
Obseg		str. 703-6
Jezik		slo
Abstrakt		Background. Twenty children (age 5 to 17.5 years) with recurring pains in stomach and microscopically established chronic gastritis due to Helicobacter pylori (HP) were treated from 1995-1997 at the Pediatric clinic in Ljubljana. The treatment with omeprazole, roxithromycine and tinidazole lasted ten days. At each child the first endoscopic procedure - oesophagogastroduodenoscopy (OGD) was performed before the treatment and the second OGD four weeks after the end of therapy when eradication of HP was established. 3-4 biopsies of antral mucosa were taken for rapid urease test (RUT), for histological examination and for culture of HP. The blood samples for specific IgG antibodies for HP were taken before and 4 weeks after the treatment. Results and conclusions. At the first OGD antral nodularity was established at 20 children, 1 had ulcus duodeni, 3 erosive gastritis, 2 erosive bulbitis, 2 bulbitis, and 2 oesophagitis. RUT was positive in 65%, culture in 25%, and histology in 100%. IgG antibodies were positive in 90%. At the second OGD normal endoscopic appearance was observed at 5 children, 2 had patchy hyperaemia of the antrum, 1 oesophagitis, and 13 children had persistent antral nodularity. RUT was positive in 5%, culture in 0%, histological improvement in 100%, decrease of specific IgG in 90%, while eradication of HP was established in 90%.
Izvleček		Izhodišča. Na Pediatrični kliniki smo letoma 1995 in 1997 zdravili 20 otrok, starih od 5 do 17,5 leta, s ponavljajočimi se bolečinami v trebuhu zaradi kroničnega gastritisa, ki je nastal zaradi okužbe z bakterijo Helicobacter pylori (HP). Zdravljenje z omeprazolom roksitromicinom in tinidazolom je trajalo 10 dni. Pri vsakem otroku smo naredili prvo endoskopsko preiskavo - ezofagogastroduodenoskopijo (EGDS) pred zdravljenjem in drugo EGDS štiri tedne po koncu zdravljenja, ko smo ugotavljali eradikacijo HP. Odvzeli smo 3-4 vzorce antralne sluznice za hitri ureazni test (HUT), za histološki pregled in za kulturo HP. Pred zdravljenjem in 4 tedne po koncu zdravljenja smo odvzeli kri za določitev specifičnih protiteles IgG na HP. Rezultati in zaključki. Ob prvi EGDS smo ugotovili nodularni videz antruma pri 20 otrocih. En otrok je imel ulkus na bulbusu dvanajstnika, trije otroci so imeli erozivni gastritis, dva eorzivni bulbitis, dva bulbitis in dva tudi ezofagitis. HUT je bil pozitiven pri 65%, kultura na HP pri 25%, histologija pa pri vseh preiskovancih. Specifična protitelesa IgG na HP so bila pozitivna v 90%. Ob drugi EGDS, torej po zdravljenju, smo ugotovili normalen endoskopski videz želodčne sluznice pri petih otrocih, dva sta imela marogasto hiperemijo antruma, eden ezofagitis, 13 otrok pa tudi nodularni videz antralne sluznice. HUT je bil pozitiven v 5%, v kulturi HP ni porasel pri nobenem otroku. Histološko izboljšanje smo ugotovili pri vseh otrocih, padec specifičnih IgG v 90% in eradikacija HP je bila ugotovljena v 90%.
Deskriptorji		GASTRITIS HELICOBACTER PYLORI ROXITHROMYCIN OMEPRAZOLE TINIDAZOLE CHILD CHRONIC DISEASE DRUG THERAPY, COMBINATION GASTROSCOPY GASTRIC MUCOSA IGG TREATMENT OUTCOME