Sýkora J, Pazdiora P, Varvarovská J, Pomahacová R, Stozický F, Siala K
Detská klinika FN a LF UK v Plzni.
Epidemiol Mikrobiol Imunol. 2006 Feb;55(1):3-16.
H. pylori infection is common worldwide, and is acquired primarily during childhood. The mechanism of acquisition is not clear. In recent years the main focus of interest has been on the transmission of infection from family members to children. The main risk factor for acquiring the infection seems to be low socioeconomic status. H. pylori is associated with gastritis, duodenal ulcers, MALT lymphoma, and gastric adenocarcinoma. Extra-intestinal clinical manifestations have also been reported. However, the infection is often asymptomatic in children and the role of H. pylori infection in gastric manifestations is the subject of conflicting reports. Methods for the diagnosis of H. pylori infection in children are subdivided into invasive and noninvasive. There is a lack of consensus on treatment. The treatment of H. pylori is hampered by high macrolide-resistance. Treatment with proton pump-based triple therapy for 1-2 weeks gives the best eradication rates when combined with supplements containing probiotics. Multinational, multicentre studies in childhood are essential to extend current knowledge to avoid long-term gastroduodenal disease sequelae.
幽门螺杆菌感染在全球范围内都很常见，主要在儿童时期获得。感染的机制尚不清楚。近年来，主要关注的焦点是感染从家庭成员传播给儿童。获得感染的主要危险因素似乎是社会经济地位低下。幽门螺杆菌与胃炎、十二指肠溃疡、黏膜相关淋巴组织淋巴瘤和胃腺癌有关。也有肠外临床表现的报道。然而，该感染在儿童中通常无症状，幽门螺杆菌感染在胃部表现中的作用存在相互矛盾的报道。儿童幽门螺杆菌感染的诊断方法分为侵入性和非侵入性。治疗方面缺乏共识。大环内酯类药物高耐药性阻碍了幽门螺杆菌的治疗。基于质子泵的三联疗法治疗1 - 2周，与含有益生菌的补充剂联合使用时根除率最佳。开展儿童期的多国、多中心研究对于扩展现有知识以避免长期胃十二指肠疾病后遗症至关重要。
