Plonka M, Bielanski W, Konturek S J, Targosz A, Sliwowski Z, Dobrzanska M, Kaminska A, Sito E, Konturek P C, Brzozowski T
Department of Clinical Physiology, Jagiellonian University Medical College, 16 Grzegorzecka St, 31-531 Cracow, Poland.
Dig Liver Dis. 2006 Feb;38(2):91-7. doi: 10.1016/j.dld.2005.10.013. Epub 2005 Nov 15.
Family unit is generally accepted as one of the contributors to Helicobacter pylori infection that is most frequently acquired in childhood, so it seems logical to diagnose and treat this infection in childhood. This study was designed to assess H. pylori prevalence in children from shepherd families having contacts with sheep.
This study involved 146 children (58 M/88 F, age 6-17 years; mean: 10.2 years) from families living in Polish Tatra Mountains with contact (group A, n=58) or without contact with sheep (group B, n=88). H. pylori status was determined by (13)C-urea breath test and was compared to 141 age- and gender-matched urban controls (group C). In both groups of mountain children, the anti-H. pylori and anti-CagA IgG were measured by ELISA and serum gastrin, ghrelin and leptin concentrations by RIA.
The H. pylori prevalence in group A was significantly higher (58.6%) than that in group B (21.6%) and urban controls (26%). Serum gastrin concentrations were significantly higher in H. pylori-positive than in H. pylori-negative mountain children (52.2+/-5.8 pmol/L versus 22.7+/-2.1 pmol/L), while serum ghrelin and leptin concentrations were significantly lower in H. pylori-infected (741+/-112 pg/mL and 3.6+/-0.8 ng/mL) than in non-infected children (1323+/-104 pg/mL and 8.6+/-2.4 ng/mL).
Children with sheep contact show about twice higher H. pylori prevalence and higher serum gastrin but lower ghrelin and leptin levels than those without H. pylori infection. Considering almost 100% positive 13C-urea breath test in sheep, it is reasonable to propose that H. pylori infection in shepherd children may originate from sheep and the infection might, therefore, be considered as zoonosis.
家庭单位通常被认为是儿童期最常见获得性幽门螺杆菌感染的促成因素之一，因此在儿童期诊断和治疗这种感染似乎是合理的。本研究旨在评估与绵羊有接触的牧羊家庭儿童中幽门螺杆菌的患病率。
本研究纳入了146名儿童（58名男性/88名女性，年龄6至17岁；平均：10.2岁），这些儿童来自生活在波兰塔特拉山脉的家庭，其中与绵羊有接触的儿童为A组（n = 58），与绵羊无接触的儿童为B组（n = 88）。通过¹³C - 尿素呼气试验确定幽门螺杆菌感染状况，并与141名年龄和性别匹配的城市对照儿童（C组）进行比较。在两组山区儿童中，通过酶联免疫吸附测定法（ELISA）检测抗幽门螺杆菌和抗细胞毒素相关基因A（CagA）免疫球蛋白G（IgG），并通过放射免疫分析法（RIA）检测血清胃泌素、胃饥饿素和瘦素浓度。
A组幽门螺杆菌患病率（58.6%）显著高于B组（21.6%）和城市对照儿童（26%）。幽门螺杆菌阳性的山区儿童血清胃泌素浓度显著高于幽门螺杆菌阴性儿童（52.2±5.8 pmol/L对22.7±2.1 pmol/L），而幽门螺杆菌感染儿童的血清胃饥饿素和瘦素浓度（741±112 pg/mL和3.6±0.8 ng/mL）显著低于未感染儿童（1323±104 pg/mL和8.6±2.4 ng/mL）。
与绵羊有接触的儿童幽门螺杆菌患病率比未感染幽门螺杆菌的儿童高出约两倍，血清胃泌素水平较高，但胃饥饿素和瘦素水平较低。考虑到绵羊的¹³C - 尿素呼气试验阳性率几乎为100%，有理由认为牧羊儿童的幽门螺杆菌感染可能源自绵羊，因此这种感染可被视为一种人畜共患病。
