【摘要】目的  探讨成都地区因上消化道症状就诊患儿行13C-尿素呼气试验（13C-UBT）检测幽门螺杆菌（Hp）感染及行胃镜检查的临床意义。方法  对4 490例有上消化道症状的患儿行13C-UBT检查，比较不同性别、年龄、症状患儿13C-UBT阳性率。对阳性患者再行胃镜检查，取胃黏膜行快速尿素酶试验。结果  有上消化道症状的4 490例儿童中，13C-UBT总阳性率为17.22%，儿童Hp感染无明显下降趋势；男女阳性率差异无统计学意义（P>0.05）；>5~11岁组和> 11~17岁组患儿阳性率分别为20. 39%和19. 97%，以腹痛为主要症状者阳性率为22.18%，差异有统计学意义（P<0.05）。在13C-UBT阳性患儿中有736例（95. 21%）接受胃镜检查，快速尿素酶试验与13C-UBT阳性符合率为95.24%。13C-UBT阳性患儿的胃镜下改变以慢性浅表性胃炎和慢性十二指肠炎最多见，消化性溃疡其次。结论  2011~2013年成都地区儿童Hp感染无明显下降趋势。13C-UBT阳性率与性别无关，但与年龄及症状相关，13C-UBT对5岁以上以腹痛为主要表现的患儿寻找病因有重要的临床意义；同时可提高患儿及家长对胃镜检查的接受度，对阳性者再行胃镜检查有助于进一步明确诊断。

【Abstract】 Objective To investigate the clinical significance of 13C-urea breath test(UBT) combined with gastroscopic examination in detecting Helicobacter pylori(Hp) infection in the children with upper gastrointestinal symptoms. Methods 13C-UBT was performed in 4 490 children with upper gastrointestinal symptoms. The positive rates of 13C-UBT were compared among children with different genders , ages and symptoms. The children with positive 13C-UBT results were performed the gastroscopic examination again and the gastric mucosa was taken for con-ducting the rapid urease test. Results  Among 4 490 children with upper gastrointestinal symptoms，the total positive rate of 13C-UBT was 17.22%, the Hp infection in children had no declining trend; there was no significant difference in the positive rate between boys and girls(P>0. 05). The positive rate of Hp infection in the > 5- 11 years old group and >11- 17 years old group were 20. 39% and 19. 97% respectively, which in the children with abdominal pain as the main symptom was 22.18%. 736 children with 13C-UBT positive results received the gastroscopie examination of Hp infection, and the positive coincidence rate of rapid urcase test and 13C-UBT was 95. 24%. The gastroscopie changes in the children with 13C-UB positive were mainly chronic superficial gastritis and chronic dodecadactylitis, followed by peptic ulcer. Conclusion  Hp infection among children in Chengdu area during 2011- 2013 has no significant declining trend. The 13C-UBT positive rate has no relation with gender, but has relation with age and symptoms. 13C-UBT has an important clinical significance for searching the etiology in the children patients aged more than 6 years old and with abdominal pain as the main manifestation; meanwhile which can increase the acceptability for the children patients and their parents to gastroscopy, the performing the gastroscopic examination in children with 13C-UBT positive is conducive to further clarify the diagnosis.