Seo Ji-Hyun, Park Heung Keun, Park Ji Sook, Yeom Jung Sook, Lim Jae-Young, Park Chan-Hoo, Woo Hyang-Ok, Youn Hee-Shang, Jun Jin-Su, Ko Gyung-Hyuck, Baik Seung-Chul, Lee Woo-Kon, Cho Myung-Je, Rhee Kwang-Ho
Department of Pediatrics, Gyeongsang National University Hospital and Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Department of Pathology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2015 Dec;18(4):246-52. doi: 10.5223/pghn.2015.18.4.246. Epub 2015 Dec 23.
To assess gastric pH and its relationship with urease-test positivity and histological findings in children with Helicobacter pylori infection.
Fasting gastric juices and endoscopic antral biopsy specimens were collected from 562 children and subjected to the urease test and histopathological examination. The subjects were divided into 3 age groups: 0-4, 5-9, and 10-15 years. The histopathological grade was assessed using the Updated Sydney System, while the gastric juice pH was determined using a pH meter.
The median gastric juice pH did not differ significantly among the age groups (p=0.655). The proportion of individuals with gastric pH >4.0 was 1.3% in the 0-4 years group, 6.1% in the 5-9 years group, and 8.2% in 10-15 years (p=0.101). The proportions of moderate and severe chronic gastritis, active gastritis, and H. pylori infiltration increased with age (p<0.005). Urease-test positivity was higher in children with hypochlorhydria (77.8%) than in those with normal gastric pH (31.7%) (p<0.001). Chronic and active gastritis were more severe in the former than the latter (p<0.001), but the degree of H. pylori infiltration did not differ (20.9% vs. 38.9%; p=0.186).
Gastric pH while fasting is normal in most children regardless of age. Urease-test positivity may be related to hypochlorhydria in children, and hypochlorhydria is in turn related to H. pylori infection.
评估幽门螺杆菌感染儿童的胃内pH值及其与尿素酶试验阳性和组织学结果的关系。
收集562名儿童的空腹胃液和内镜下胃窦活检标本，进行尿素酶试验和组织病理学检查。将受试者分为3个年龄组：0 - 4岁、5 - 9岁和10 - 15岁。使用更新的悉尼系统评估组织病理学分级，同时使用pH计测定胃液pH值。
各年龄组之间的胃液pH值中位数无显著差异（p = 0.655）。胃内pH值>4.0的个体比例在0 - 4岁组为1.3%，5 - 9岁组为6.1%，10 - 15岁组为8.2%（p = 0.101）。中度和重度慢性胃炎、活动性胃炎以及幽门螺杆菌浸润的比例随年龄增加（p < 0.005）。胃酸过少儿童的尿素酶试验阳性率（77.8%）高于胃pH值正常的儿童（31.7%）（p < 0.001）。前者的慢性和活动性胃炎比后者更严重（p < 0.001），但幽门螺杆菌浸润程度无差异（20.9%对38.9%；p = 0.186）。
大多数儿童空腹时胃内pH值正常，与年龄无关。儿童尿素酶试验阳性可能与胃酸过少有关，而胃酸过少又与幽门螺杆菌感染有关。
