Choe Y H, Lee J E, Kim S K
Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Inchon, South Korea.
Acta Paediatr. 2000 Feb;89(2):154-7. doi: 10.1080/080352500750028753.
We investigated the effect of Helicobacter pylori eradication on sideropenic refractory anaemia in adolescent girls with H. pylori-associated antral gastritis without evidence of haemorrhage or clinical symptoms other than sideropenic anaemia. We conducted an open therapeutic trial in 21 adolescent girls aged 15-17 y with sideropenic refractory anaemia, which was defined as iron-deficiency anaemia refractory to oral iron therapy for 3 mo. All subjects underwent gastroduodenal endoscopy. Thirteen patients with confirmed H. pylori infection were given a 2-wk course of triple therapy and 6 wk of oral ferrous sulfate. We compared the mean levels of haemoglobin and serum ferritin among the "initial sample" (the time when the sampling was done before treatment with oral iron), "before eradication" (the time prior to triple therapy for eradication after subjects had been given oral iron for 3 mo) and "after eradication" (the time when the follow-up endoscopy was performed) data in 11 subjects in whom H. pylori infection was eradicated. Haemoglobin levels (g/dl) were 8.6+/-1.9, 8.6+/-1.4 and 11.3+/-2.3, respectively. Serum ferritin levels (microg/l) were 4.6+/-2.4, 4.2+/-2.3 and 17.5+/-6.7, respectively. After eradication of H. pylori, mean levels of haemoglobin (p = 0.0002) and serum ferritin (p = 0.0002) showed a prominent increase between "before eradication" and "after eradication". In conclusion, adolescent girls with sideropenic refractory anaemia should be evaluated for H. pylori infection. If H. pylori infection is coexistent, its eradication along with iron supplementation could correct the anaemia.
我们研究了根除幽门螺杆菌对患有幽门螺杆菌相关性胃窦炎、无出血证据且除缺铁性贫血外无其他临床症状的青春期女孩缺铁性难治性贫血的影响。我们对21名年龄在15 - 17岁、患有缺铁性难治性贫血(定义为口服铁剂治疗3个月后仍难治的缺铁性贫血)的青春期女孩进行了一项开放性治疗试验。所有受试者均接受了胃十二指肠内镜检查。13名确诊幽门螺杆菌感染的患者接受了为期2周的三联疗法和6周的口服硫酸亚铁治疗。我们比较了11名幽门螺杆菌感染已根除的受试者在“初始样本”(口服铁剂治疗前采样时)、“根除前”(受试者口服铁剂3个月后进行根除三联疗法前)和“根除后”(进行随访内镜检查时)数据中的血红蛋白和血清铁蛋白平均水平。血红蛋白水平(g/dl)分别为8.6±1.9、8.6±1.4和11.3±2.3。血清铁蛋白水平(μg/l)分别为4.6±2.4、4.2±2.3和17.5±6.7。根除幽门螺杆菌后,血红蛋白(p = 0.0002)和血清铁蛋白(p = 0.0002)的平均水平在“根除前”和“根除后”之间显著升高。总之,患有缺铁性难治性贫血的青春期女孩应评估是否感染幽门螺杆菌。如果同时存在幽门螺杆菌感染,根除幽门螺杆菌并补充铁剂可纠正贫血。