幽门螺杆菌感染儿童的胃组织病理学、铁状态与缺铁性贫血
Gastric histopathology, iron status and iron deficiency anemia in children with Helicobacter pylori infection.
作者信息
Baysoy Gökhan, Ertem Deniz, Ademoğlu Evin, Kotiloğlu Esin, Keskin Sabiha, Pehlivanoğlu Ender
机构信息
Division of Pediatric Gastroenterology and Nutrition, Istanbul University Istanbul Faculty of Medicine, Turkey.
出版信息
J Pediatr Gastroenterol Nutr. 2004 Feb;38(2):146-51. doi: 10.1097/00005176-200402000-00008.
OBJECTIVES
Helicobacter pylori has been established as a major cause of gastritis and peptic ulcer disease in adults and children. H. pylori infection may also have a role in the development of some extra-gastrointestinal diseases, including iron deficiency anemia. The aim of this study is to investigate H. pylori-related changes in gastric physiology and histology and the relationship of these changes to iron deficiency anemia in children.
METHODS
Fifty-two patients with gastrointestinal complaints were studied. Hematologic parameters, 3-day vitamin C and iron consumption, serum gastrin levels, and gastric juice ascorbic acid levels were compared in patients with and without H. pylori infection. Dietary intake of vitamin C and iron, serum gastrin, gastric juice ascorbic acid content, and gastric histology were compared in patients with H. pylori infection and anemia and in patients with H pylori infection and no anemia. The CagA status of the H. pylori organisms was evaluated.
RESULTS
Twenty-eight of 52 patients had H. pylori. Thirty-one patients had iron deficiency anemia. H. pylori infection was associated with low serum iron levels. H. pylori gastritis was associated with a decrease in the gastric juice ascorbic acid level. Infection with CagA-positive strains was associated with a greater decrease in gastric juice ascorbic acid than infection with CagA-negative strains. However, the gastric juice ascorbic acid levels of patients with H. pylori and anemia were not different from those of non-anemic patients with H. pylori. Among patients with H. pylori infection, pangastritis was twice as common in those with anemia than in those without anemia.
CONCLUSIONS
H. pylori infection was associated with a decrease in gastric juice ascorbic acid concentration, and this effect was more pronounced in patients with the CagA-positive strain. Pangastritis was more common in patients whose H. pylori.infection was accompanied by anemia.
目的
幽门螺杆菌已被确认为成人和儿童胃炎及消化性溃疡病的主要病因。幽门螺杆菌感染在包括缺铁性贫血在内的一些胃肠外疾病的发生中可能也起作用。本研究的目的是调查儿童中幽门螺杆菌相关的胃生理和组织学变化以及这些变化与缺铁性贫血的关系。
方法
对52例有胃肠道不适的患者进行研究。比较了幽门螺杆菌感染患者和未感染患者的血液学参数、3天维生素C和铁的摄入量、血清胃泌素水平以及胃液中维生素C水平。比较了幽门螺杆菌感染并贫血的患者和幽门螺杆菌感染但未贫血的患者的维生素C和铁的饮食摄入量、血清胃泌素、胃液维生素C含量以及胃组织学。评估了幽门螺杆菌菌株的CagA状态。
结果
52例患者中有28例感染了幽门螺杆菌。31例患者患有缺铁性贫血。幽门螺杆菌感染与血清铁水平低有关。幽门螺杆菌胃炎与胃液中维生素C水平降低有关。与CagA阴性菌株感染相比，CagA阳性菌株感染导致胃液中维生素C的降低幅度更大。然而，幽门螺杆菌感染并贫血患者的胃液维生素C水平与未贫血的幽门螺杆菌感染患者的胃液维生素C水平没有差异。在幽门螺杆菌感染患者中，全胃炎在贫血患者中的发生率是未贫血患者的两倍。
结论
幽门螺杆菌感染与胃液中维生素C浓度降低有关，且这种影响在CagA阳性菌株患者中更明显。全胃炎在幽门螺杆菌感染伴贫血的患者中更常见。
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