ЭТИОЛОГИЧЕСКИЕ ФАКТОРЫ ХРОНИЧЕСКИХ ГАСТРИТОВ У ДЕТЕЙ

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    : , , : 125412, , . , . 2, . (495) 487B46B81 22.10.2005 ., 14.03.2006 .

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    145 . 40% . HELICOBACTER PYLORI (H. PYLORI) 44,8% . 27,6% . . H. PYLORI( ) ( ). : , , , , , , HELICOBACTER PYLORI.

    Etiological factors of chronicgastritis in children

    G.V. Volynets

    Moscow Research Institute of Pediatrics and Children'sSurgery, the Federal Agency for Healthcare and SocialDevelopment (Roszdrav)

    IN THE ARTICLE THE DATA ON THE STUDY OF THE ETIOLOGICAL FACTORS OFVARIOUS TYPES OF CHRONIC GASTRITIS IN CHILDREN ARE PRESENTED.BASED ON REVEALING OF THE AUTOANTIBODIES TO PARIETAL GASTRICCELLS IN 40,0% OF CHILDREN AUTOIMMUNE GASTRITIS (A TYPE GASTRITIS)IS DIAGNOSED. HELICOBACTER PYLORI INFECTION IS REVEALED IN 44,8% OFCHILDREN. IN 27,6% OF CHILDREN TYPE C GASTRITIS IS DIAGNOSED.AUTOIMMUNE GASTRITIS IN CHILDREN HAS BEEN LINKED TO THE ACTIVEPHASE OF CHRONIC EPSTEINBBARR VIRUS INFECTION. THE ETIOLOGICALFACTORS OF NONAUTOIMMUNE GASTRITIS ARE HELICOBACTER PYLORIINFECTION (TYPE B GASTRITIS) AND MULTIPLE DUODENOGASTRIC REFLUXES(TYPE C GASTRITIS).KEY WORDS: CHILDREN, CHRONIC GASTRITIS, ETIOLOGICAL FACTORS,AUTOIMMUNE GASTRITIS, NONAUTOIMMUNE GASTRITIS, ACTIVE PHASEOF CHRONIC EPSTEINBARR VIRUS INFECTION, HELICOBACTER PYLORIINFECTION.

    . : ( B); , H. pylori ( ), (, B , , B, , ) [1, 2]. , H. pylori B , B B [35]. , H. pylori B [6, 7]. B B , . H. pylori, B , , . , , B, , B [812]. B B [1316]. B [1]. McIntyre et al. 1965 . . B , [17]. ,

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    , 13 14% [18, 19]. B B , [1, 2026]. B . B [27]. B , [28]. 30% H+/K+B, . B [21,29]. B , B H+/K+B B [21, 30, 31]. . , , B , B . B , B [28]. BB , B [30]. B , B [3235]. , B [36]. 36% B , B, [37]. B , [36]. B B H. pylori 6,5%. [37]. B B, , B . , B [21, 38]. B , B, 11 12 [39]. B , B , B, I , , B. , , B [38, 40]. , B [41]. H. pylori B . , H. pylori [42, 43]. H. pylori B

    , . , 3050% B . H. pylori [23, 4446]. B, , , H. pylori, [47]. , 27,7% H. pyloriB H+/K+B. , , , B [4850]. H. pyloriB S. Eight et al. 1996 . B B , . ylori [51]. [52]. M. Stolte et al. (1998) . ylori [53]. , B H. pylori B , B [54, 55]. , B , B .

    2002 . 2006 . 145 (79 66 ) 3 17 ( 10,1 0,3 ) . 3 . 70 (37 33 ) 3 17 ( 10,1 0,5 ). , 6 , 2 B , B . B H. pylori B 2 . B 30 , B H. pyloriB. 40 H. pyloriB. 58 (35 23 B) 4 17 ( 10,8 0,5 ). B . H. pylori 2 . B 23 , H. pylori ( ). 35 H. pylori ( +). B ( B, , , B , B

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    ), , B . ( ) 17 7,0 0,8 B, B . B H. pylori, . B B OLYMPUS VB160 (B). BB H. pylori H. pylori (, ). B H. pylori Helicobacter pylori ( , ). , B IgG H. pylori (). B B 1:20 B B . B 1:10 , B . B B (IgM, IgG) 12 , IgM, IgG (), B HUMAN (B), BioRad (), B (). 1 2 , B , B . B BB . 290 .. BB100BR (. N VB9B100BR), B 1000 B / (B BB B ). B B B . .. B . .. . B, B B B. : IgG B

    1015 ..;

    IgM ;

    IgG B ;

    .

    : IgG B

    1015 ..;

    IgG /

    IgM B /

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    B B BB5 B (). B , B B B B ().

    1 2 , IgM B. IgG 1 2 B 1:800 1:12800 16 (11,1%); 14 (9,7%) 1:1600. 12 . B 2 (1,4%) . , IgM 6 (4,2%); IgG 1:800 1:6400 21 (14,6%) , 11 (7,6%) 1:1600. , B 4 (2,1%) . B B 1 (0,7%) . B IgM IgG. B 111 (76,6%). 35 (31,5%), 76 (68,5%) . 44 B . H. pylori , B IgG H. pylori 65 (44,8%) . B, B 117 145 (80,7%). B 93 (64,1%) 145 , B 73 (50,3%) 145. B 49 (33,8%) 145 .

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    58 (40,0%) B , B . B , B, , B , B . B (1:201:40) B (.), B B B . , , B . 26 H. pylori, B . 17 65,4%) B ( B , B . 9 (34,6%) BB . B B , H. pylori B . 1. , B B

    (55 111 49,5% 3 34 8,8% ; 2 = 16,330; p < 0,001). B (5 35 14,3%) (2 = 0,111; p = 0,740) . . B 50 (65,8%) 76, , (2 = 23,411; p < 0,001). B , B (40 44 90,9%). H. pylori B . H. pylori B 4 24 (16,7% B). H. pylori 31 (75,6%) 41, (2 = 18,858; p < 0,001). H. pylori 19 (54,3%) 35. ,

    (n = 145) 22 (15,2%)

    (n = 58) 10 (17,2%)

    (n = 70) 9 (12,9%)

    3 (17,6%), (n = 17)

    .

    20 (13,8%)

    12 (20,7%)

    5 (7,1%)

    3 (17,6%)

    19 (13,1%)

    9 (15,5%)

    9 (12,9%)

    1 (5,9%)

    8 (5,5%)

    2 (3,4%)

    7 (10,0%)

    1 (5,9%)

    . 1. ( %) B (), H. pylori

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    H. pylori, 31 (75,6%) 41, B B (2 = 2,926; p = 0,087) B B H. pylori, . B H. pylori 57 (51,4%) 111, 32 (56,1%) B 57. H. pylori 54 (48,6%) 111, 22 (40,7%) 54. (2 = 2,1; p = 0,152) B . B , B H. pylori. H. pylori 26 (89,7%) 29, H. pylori 14 (93,3%) 15; 2 = 0,023;p = 0,880. , B , , B H. pylori. , 23 (39,7%) 58 H. pylori, 5 (8,6%) B B , B , + (B , B ). 23 B , B (. 2). 35 (60,3%) 58 H. pylori, 32 . + ( , B , H. pylori ). 6 (10,3%) B . B B ++ ( ,

    , H. pylori B B ). , 55(94,8%) 58 B . 35(60,3%) 58 B H. pylori. H. pylori B 31 (88,6%) 35, B 4 (11,4%) B 35; 2 = 42,299; < 0,001. B H. pylori 19 (32,8%) 58, B H. pylori 4 (6,9%) 58; 2 = 10,629; < 0,001. 70 B . , 70 40 (57,1%) B ( ). 30 (42,9%) B H. pylori B . 15 B B . + ( B , B )( 3).

    B 56 (80,0%) 70. (2 = 23,411;p < 0,001) (30 B 56 53,6%), (5 55 9,1%). (4 56 7,1%) B , (40 55 72,7%); 2 = 47,179; p < 0,001. , 26 (37,1%) 70,

    . 2.

    . 3.

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    44 (62,9%) 70. 30 (42,9%) 70 B H. pylori. H. pylori B 10 (14,3%) 70, 20 (28,6%) 70. B 16 (40,0%) 40, 24 (60,0%) 40. B ( ) B , H. pylori, B B B . , ( ), B H. pylori ( +). , B , ( ) (. 4). B

    ( ), H. pylori( ). , B , B B ( +). B , B (. 4). [12, 13]. B B BB , , B , B B . , :1. B 40% B , . 86,2% B , 60,3% H. pylori. B 6,9% . 2. B 48,3% 42,9% H. pyloriB, 57,1% B B . B .

    . 4. (n = 145)

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