Risk factor analysis of pediatric Helicobacter pylori infection of rural areas in Shaanxi Province and its correlation with chronic mesenteric lymphadenitis
Objective:To investigate the epidemiological characteristics and independent risk factors of pediat-ric Helicobacter pylori(HP)infection in rural areas of Shaanxi Province,and to explore the correlation between HP infection and chronic mesenteric lymphadenitis(MLN).Methods:To collect clinical information from children who had 13C urea breath tests in the Second Affiliated Hospital of Xi'an Jiaotong University(Xi'an),Zizhou County Traditional Chinese Medicine Hospital(Yulin),and Mian County Traditional Chinese Medicine Hospital(Hanzhong)from September 2020 to October 2023.We completed the logistic regression analyses of risk factors for HP infection and the association between HP infection and chronic MLN,as well as the basic analyses of HP infection and the characteristics of chronic MLN.Results:The study included a total of 709 rural children in the northern,central,and southern regions of Shaanxi Province,including 329 HP-positive cases and 380 HP-nega-tive cases.The HP infection rate was 46.40％.There were 112 children with chronic MLN and 597 children with-out chronic MLN,and the prevalence of MLN was 15.80％.The basic study of HP infection revealed significant differences in HP infection rates among different age groups(all P＜0.001).The age group of＞15 to 18 years old had the greatest infection rate among the minors.The prevalence of HP infection in rural boys in Xi'an was substantially greater than that in girls(P＜0.01).Compared to Yulin and Hanzhong,the infection rate among ru-ral children in Xi'an was also considerably higher(both P＜0.01).Children with a family size of less than four,those who shared toothbrush cups,shared tableware,did not wash their hands before and after using the re-stroom,enjoyed snacking,and had immediate relatives with a history of gastrointestinal illness,achieved a signifi-cantly higher rate of HP infection(all P＜0.001).Analysis of characteristics of HP infection and chronic MLN showed that children with HP had significantly higher counts of white blood cells,monocytes,C-reactive protein,procalcitonin,interleukin 6,immunoglobulin G,complement C3,complement C4,but except for CD3+count,CD4+count,and CD8+count(all P＜0.05).The HP infection rate in children with purpura was significantly higher than those with anemia and oral ulcers(all P＜0.05).In children infected with HP,there was a substantial increase in the maximal short diameter of abdominal lymph nodes,intestinal wall edema,and depth of peritoneal fluid dark regions(all P＜0.01).C-reactive protein,procalcitonin,immunoglobulin G,complement C3,comple-ment C4,CD4+count,CD8+count,CD4+/CD8+in children with chronic MLN were significantly higher than those without MLN(all P＜0.05).The prevalences of MLN in children with anemia,oral ulcers,and slow devel-opment were equal,which were significantly higher than that in children with purpura(all P＜0.05).The maxi-mum diameter of abdominal lymph nodes in children with chronic MLN was significantly increased(P＜0.01).Logistic regression analysis of risk factors for HP showed that gender,living area,sharing tableware,not washing hands before meals and after using the toilet,liking snacks,recurrent abdominal pain,and indigestion symptoms were all independent risk factors(all P＜0.05).Logistic regression analysis of the correlation between HP infec-tion and chronic MLN showed that the odds ratio(OR)in the unadjusted model was 2.324(95％CI:1.427-3.785,P＜0.001).When adjusting for age,gender,living area,sharing toothbrush cups,sharing tableware,eating snacks,nausea,and vomiting,the OR was 2.352(95％CI:1.501-3.686,P＜0.001).Conclusion:In ad-dition,the independent risk factors for HP infection are gender,living area,sharing tableware,washing hands be-fore meals and after using the restroom,liking snacks,recurrent abdominal pain,and indigestion symptoms in Shaanxi Province.Furthermore,HP infection is an important risk factor for chronic MLN in Shaanxi Province.
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