Park Jae H, Kim Su Y, Kim Dong W, Lee Woo G, Rhee Kwang H, Youn Hee S
Department of Pediatrics, College of Medicine, Pusan National University, Pusan, Korea.
J Pediatr Gastroenterol Nutr. 2003 Jul;37(1):53-62. doi: 10.1097/00005176-200307000-00009.
It is well known that chronic gastritis induced by Helicobacter pylori may be associated with hypochlorhydria and may also be accompanied by low levels of vitamin C in plasma and gastric juice in adults. This study investigates the relationship between H. pylori infection and vitamin C levels in the blood, plasma and gastric juice and the gastric juice pH of Korean children.
During a 5-year period, multiple gastric antral biopsies were taken from 452 children who underwent gastroduodenoscopy. The biopsy specimen was inoculated into phenol red buffered urea broth and incubated for 48 hours to detect color changes. The histopathologic findings were evaluated using the Sydney System. Concentrations of vitamin C in whole blood, plasma, and gastric juice aspirate were measured using the 2,4-dinitrophenylhydrazine method.
Four hundred fifty-two patients (228 boys, 224 girls) aged 1 to 15 years were enrolled in this study. H. pylori was detected in 112 patients (24.8%) using histology, whereas it was found in 204 patients (45.1%) using the urease test. One hundred seven patients (23.7%) had active gastritis, and 421 patients (93.1%) had chronic gastritis. Vitamin C levels in whole blood, plasma, and gastric juice exhibited significant negative correlation with the age of patients, the histologic density of H. pylori, the degree of active and chronic gastritis, and the severity of H. pylori infection (based on urease positivity and histologic density of H. pylori). Gastric juice pH was correlated with the degree of chronic gastritis and was significantly higher in urease-positive patients.
The data demonstrate that vitamin C levels in whole blood, plasma, and gastric juice and the gastric juice pH in Korean children are closely related to the severity of H. pylori infection and the histologic changes in the stomach. These data suggest that vitamin C may play a role in determining infection and progression, and vitamin C supplementation may be an important axis for the management of H. pylori infection in children.
众所周知，幽门螺杆菌引起的慢性胃炎可能与胃酸分泌过少有关，并且在成年人中还可能伴有血浆和胃液中维生素C水平降低。本研究调查了韩国儿童幽门螺杆菌感染与血液、血浆和胃液中维生素C水平以及胃液pH值之间的关系。
在5年期间，对452例接受胃十二指肠镜检查的儿童进行了多次胃窦活检。将活检标本接种到酚红缓冲尿素肉汤中，孵育48小时以检测颜色变化。使用悉尼系统评估组织病理学结果。采用2,4-二硝基苯肼法测定全血、血浆和胃液抽吸物中维生素C的浓度。
本研究纳入了452例年龄在1至15岁的患者（228例男孩，224例女孩）。通过组织学检测，在112例患者（24.8%）中检测到幽门螺杆菌，而通过尿素酶试验在204例患者（45.1%）中检测到幽门螺杆菌。107例患者（23.7%）患有活动性胃炎，421例患者（93.1%）患有慢性胃炎。全血、血浆和胃液中的维生素C水平与患者年龄、幽门螺杆菌的组织学密度、活动性和慢性胃炎的程度以及幽门螺杆菌感染的严重程度（基于尿素酶阳性和幽门螺杆菌的组织学密度）呈显著负相关。胃液pH值与慢性胃炎的程度相关，在尿素酶阳性患者中显著更高。
数据表明，韩国儿童全血、血浆和胃液中的维生素C水平以及胃液pH值与幽门螺杆菌感染的严重程度和胃部的组织学变化密切相关。这些数据表明，维生素C可能在确定感染和病情进展中起作用，补充维生素C可能是儿童幽门螺杆菌感染管理的一个重要方面。
