¹³C-urea Breath Test For Diagnosis Of Helicobacter Pylori Infection In Children And Analysis Of Clinical Characteristics

Objective:To study the value of ¹³C-urea breath test in Helicobacter pylori infection in children and to analyze the clinical characteristics of Helicobacter pylori infection in children.Methods:The results of ¹³C-urea breath test（Delta over baseline,DOB）and clinical characteristics of 2361 children with gastrointestinal symptoms in Jiangxi provincial Children’s Hospital from May 2021 to March 2022 were retrospectively analyzed.All children underwent ¹³C-urea breath test and blood routine,and 169 of them underwent gastroscopy and pathological histological examination.They were classified by age into preschool（4-6 years）,school age（7-11 years）and adolescence（12-16 years）.Results:（1）There were 2361 children,1317 males and 1044 females,male:female=1.26:1,with a median age of 8 years old（4～16 years old）.There were 827 cases of preschool age,1235 cases of school age and 299 cases of adolescence.（2）Among 2361 children with gastrointestinal symptoms,the clinical manifestations of positive Helicobacter pylori were abdominal pain in 489 cases（70.06%）,nausea and vomiting in 78 cases（11.17%）,nausea in 52 cases（7.45%）,oral odor in 29 cases（4.15%）,and other symptoms in 50 cases（7.16%）;the clinical manifestations of negative Helicobacter pylori were abdominal pain in 1162 cases（69.87%）,nausea and vomiting in 191 cases（11.49%）,nausea in 117 cases（7.04%）,oral odor in 89 cases（5.35%）,and other symptoms in 104 cases（6.25%）;There was no statistically significant difference between positive and negative clinical manifestations of Helicobacter pylori（P=0.70）.（3）The positive rate of Helicobacter pylori was 29.56%（698/2361）,Among them,the positive rate in early school age was 22.37%（185/827）,33.36%（412/1235）in school age and 33.78%（101/299）in adolescence.There was a statistical difference in the positive rate of Helicobacter pylori between the three data sets（c²=31.65,P<0.001）.There was no statistical difference in the positive rate of Helicobacter pylori in schoolage compared with puberty（P>0.05）,and there was a statistical difference between preschool and school age and puberty（P<0.001）.（4）The positive rate of Helicobacter pylori was 23.68%in males and 20.92%in females;The positive rate of Helicobacter pylori in male and female school-age students was 35.70%and 30.26%;The positive rate of Helicobacter pylori was34.64%in male and 32.50%in female;The positive rate of Helicobacter pylori in males was higher than that in females at all ages.（5）¹³C-urea breath DOB values did not correlate with gastroduodenal disease（P>0.05）.（6）In the Helicobacter pylori infection-positive group,the incidence of hemoglobin below the lower limit of normal was 17.91%（125/698）;in the Helicobacter pylori infection-negative group,the incidence of hemoglobin below the lower limit of normal was 11.55%（192/2086）,and the difference between the two groups was statistically significant（P<0.001）.Conclusions:（1）The prevalence of Helicobacter pylori infection in children is higher,is higher in males than in females,and increases with age.（2）¹³C-urea breath test was helpful in the diagnosis of Helicobacter pylori infection in children,but ¹³C-urea breath DOB value could not be used as a basis for determining the extent of gastroduodenal disease caused by Helicobacter pylori infection.（3）Helicobacter pylori infection can lead to the development of anemia in children.