Gheibi Sh, Farrokh-Eslamlou H R, Noroozi M, Pakniyat A
Associate Professor of Pediatric Gastroenterology, Maternal and Childhood Obesity research Center, Urmia University of Medical Sciences, Shahid Motahari Hospital, Urmia, Iran.
Associate Professor of Maternal and Child Health, Reproductive Health Research Center, Urmia University of Medical Sciences. Urmia, I.R. Iran.
Iran J Ped Hematol Oncol. 2015;5(1):50-64. Epub 2015 Mar 15.
Since the discovery of Helicobacter pylori, several clinical reports have demonstrated that H. Pylori infection has emerged as a new cause of refractory iron stores in children. We carried out a systematic literature review to primarily evaluate the existing evidence on the association between childhood H. Pylori infection and iron deficiency anemia (IDA) and secondly, to investigate the beneficial effects of bacterium elimination.
This review concerns important pediatric studies published from January 1991 to October 2014. Fourteen case reports and series of cases, 24 observational epidemiologic studies, seven uncontrolled trials, and 16 randomized clinical trials were included in the review.
Although there are a few observational epidemiologic studies and some randomized trials mostly due to the potential confounders, most studies reported a positive association linking between H. Pylori infection and iron deficiency or iron deficiency anemia among children. In addition, it seems that elimination of H. Pylori infection induces beneficial effects on iron deficiency.
Since the evidence for the association of H. pylori eradication therapy and refractory childhood IDA is not enough and there are contrasting data about such association, future high quality and cohort researches are needed to determine the causal association.
自幽门螺杆菌被发现以来，多项临床报告表明，幽门螺杆菌感染已成为儿童难治性铁储备的新病因。我们进行了一项系统的文献综述，主要评估关于儿童幽门螺杆菌感染与缺铁性贫血（IDA）之间关联的现有证据，其次，研究除菌的有益效果。
本综述涉及1991年1月至2014年10月发表的重要儿科研究。纳入综述的有14篇病例报告和病例系列、24项观察性流行病学研究、7项非对照试验以及16项随机临床试验。
尽管由于潜在的混杂因素，仅有少数观察性流行病学研究和一些随机试验，但大多数研究报告称儿童幽门螺杆菌感染与缺铁或缺铁性贫血之间存在正相关。此外，根除幽门螺杆菌感染似乎对缺铁有有益影响。
由于幽门螺杆菌根除治疗与儿童难治性IDA之间关联的证据不足，且关于这种关联的数据存在矛盾，未来需要高质量的队列研究来确定因果关系。
