Raymond Josette, Kalach Nicolas
Service de bactériologie, hôpital Cochin, Paris.
Rev Prat. 2006 Jan 15;56(1):5-12.
Helicobacter pylori infection is basically acquired during infancy. H. pylori is associated with a great number of pathologies including gastritis, gastroduodenal peptic ulcer, gastric adenocarcinoma and MALT lymphoma. Its association with abdominal pain in children remains controversial. An association with iron deficiency anemia was recently described. The reference method for diagnosis still remains culture and histology of gastric biopsies realized during endoscopy. A few years ago, a lot of studies have shown the reliability of non-invasive tests (urea breath test 13C and the H. pylori stool antigen) for the diagnosis of the H. pylori infection in children. The treatment associating a proton pump inhibitor with two antibiotics (depending on the antimicrobial susceptibility when it's available) is recommended every time infection is proved. In children, the reinfection rate after H. pylori eradication is often higher than in adults. The eradication of H. pylori infection does not seem to produce the advent or the aggravation of gastro-oesophageal reflux oesophagitis. The eradication of this pathogen, in children as well as in adults, should theoretically lead to the disappearance of gastric cancer.
幽门螺杆菌感染基本上在婴幼儿期获得。幽门螺杆菌与大量疾病有关,包括胃炎、胃十二指肠消化性溃疡、胃腺癌和黏膜相关淋巴组织淋巴瘤。其与儿童腹痛的关联仍存在争议。最近有报道称其与缺铁性贫血有关。诊断的参考方法仍然是在内镜检查期间对胃活检组织进行培养和组织学检查。几年前,许多研究表明非侵入性检测(13C尿素呼气试验和幽门螺杆菌粪便抗原检测)在诊断儿童幽门螺杆菌感染方面具有可靠性。每次证实感染后,建议使用质子泵抑制剂联合两种抗生素进行治疗(如有药敏结果则根据药敏情况选择抗生素)。在儿童中,幽门螺杆菌根除后的再感染率通常高于成人。根除幽门螺杆菌感染似乎不会导致胃食管反流性食管炎的出现或加重。理论上,根除这种病原体在儿童和成人中都应能使胃癌消失。
Rev Prat. 2006-1-15
Praxis (Bern 1994). 1996-9-24
Arch Pediatr Adolesc Med. 2005-5
Dig Liver Dis. 2008-8
Hokkaido Igaku Zasshi. 2004-3
Gastroenterologist. 1997-12
Curr Opin Organ Transplant. 2008-12
Am J Clin Pathol. 2003-3
Ugeskr Laeger. 2000-6-26