Objective To determine the value of serum
bismuth concentration in normal children and the safety of colloidal bismuth substrate
(CBS) of treating dosage Methods The atomic fluorescent spectrometry was used to determine the serum bismuth
concentration in 97 normal children aged from 1 to 12 years and 94 children patients aged 5 to 12 years who were diagnosed by gastroscopy as suffering from Helicobacter pylori related gastroentestinal diseases The patients were treated with a program of taking CBS for six weeks, combined with amoxicillin two weeks and metronidazole two weeks To observe the trend of serum bismuth concentration, the observations were conducted for one, two, four and six weeks after taking CBS Then one week, one to two
months, three to four months, five to six months and over six months after stopping CBS treatment the observations were conducted again Results (1) The serum bismuth concentrations of normal children among different age groups were significantly different ( F =13 75, P = 0 000 1) Serum bismuth concentrations of the normal children increased with age and were relatively stable after 5 6 years of age (2) The serum bismuth concentration in different groups of patients taking CBS showed F =37 18, P = 0 000 1 There were significant differences between the 4 week, 6 week groups and the 1 week, 2 week groups, P <0 05 Serum bismuth concentrations gradually elevated 4 weeks after taking the CBS with an average level of (10 2±2 4) or (10 8±2 1) μg/L, which was far lower than the critical value (50～100 μg/L) (3) Serum bismuth concentrations declined very slowly after the CBS treatment was discontinued Returning to the normal level required 6 to 12 months, which is longer than the process in adults (4) The overall effectiveness of combined therapy with the 3 agents, was 95%, the eradication rate of Hp was 86 % The side effect occurred in 5% of the cases Conclusion It is safe for children to take CBS of treatment dosage and the bismuth toxicosis may not occur Using the combined therapy containing CBS to treat children with Hp related gastroentestinal disease may bring satisfying results