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初次幽门螺杆菌感染并不能预防儿童根除治疗后再次感染。

A primary Helicobacter pylori infection does not protect against reinfection in children after eradication therapy.

作者信息

Leal Yelda A, Gómez Alejandro, Madrazo-de la Garza Armando, Ramos Irma, Muñoz Onofre, Torres Javier

机构信息

Unidad de Investigación Médica, Unidad Médica de Alta Especialidad del Centro Médico Nacional "Ignacio García Téllez" IMSS Mérida, Yucatán.

出版信息

Rev Invest Clin. 2008 Nov-Dec;60(6):470-7.

Abstract

BACKGROUND

Helicobacter pylori infection is one of the most common chronic infections in the world, and is acquired mainly during childhood. It is not clear to which extent a primary infection protects the child from reinfection. Our aim was to determine the possible protection conferred by a primary infection against H. pylori reinfection in children.

METHODS

A follow-up study with 120 children distributed in two cohorts; the first included 80 children without previous H. pylori infection (primo-infection cohort); the second included 40 infected children successfully eradicated (reinfection cohort). Cohorts were monitored during 2 years with urea-breath-test (UBT) at 3, 6, 9, 12, 18 and 24 months for the acquisition of H. pylori infection. We compared the rate of reinfection in eradicated children with the rate of infection in children without previous infection. H. pylori infection during the follow-up was analyzed and compared between cohorts using chi2 and survival curves. A questionnaire was performed for the evaluation of possible risk factors for infection in both cohorts.

RESULTS

No significant differences in rates of primo-infection or reinfection were found; 17 (21.2%) primo-infections and 10 (25%) reinfections were documented. Most of the primo-infections (14/17) occurred in the first year of follow-up. In contrast, reinfection episodes occurred more frequently during the second year (6/10). In both cohorts, most infections were transient. Risk factors were similar for both, primo and reinfection cohorts.

CONCLUSION

A primary infection does not protect from reinfection in the population of children studied.

摘要

背景

幽门螺杆菌感染是世界上最常见的慢性感染之一,主要在儿童期获得。目前尚不清楚初次感染在多大程度上能保护儿童免受再次感染。我们的目的是确定初次感染对儿童幽门螺杆菌再次感染可能产生的保护作用。

方法

对120名儿童进行随访研究,分为两个队列;第一个队列包括80名既往无幽门螺杆菌感染的儿童(初次感染队列);第二个队列包括40名成功根除感染的儿童(再次感染队列)。在2年的时间里,分别在第3、6、9、12、18和24个月通过尿素呼气试验(UBT)对两个队列进行监测,以了解幽门螺杆菌感染情况。我们将根除感染儿童的再次感染率与未感染儿童的感染率进行了比较。使用卡方检验和生存曲线对随访期间两个队列的幽门螺杆菌感染情况进行分析和比较。对两个队列进行问卷调查,以评估可能的感染危险因素。

结果

初次感染率和再次感染率之间未发现显著差异;记录到17例(21.2%)初次感染和10例(25%)再次感染。大多数初次感染(14/17)发生在随访的第一年。相比之下,再次感染事件在第二年更为频繁(6/10)。在两个队列中,大多数感染都是短暂的。初次感染队列和再次感染队列的危险因素相似。

结论

在所研究的儿童群体中,初次感染并不能预防再次感染。

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