Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Teaching Hospital, Sapienza University of Rome, Rome, Italy.
Pediatric and Pediatric Emergency Unit, Children Hospital, AO SS Antonio E Biagio E C. Arrigo, Alessandria, Italy.
BMC Pediatr. 2024 Jun 29;24(1):417. doi: 10.1186/s12887-024-04902-z.
BACKGROUND: The relationship between Helicobacter-pylori(Hp)infection and inflammatory-bowel-disease(IBD) in pediatric-patients remains controversial. We aimed to assess the Hp-infection occurrence in newly-diagnosed pediatric-patients with IBD compared to no-IBD patients. Additionally, we aimed to examine differences in clinical-activity-index(CAI) and endoscopic-severity-score(ESS)between IBD-patients with and without Hp-infection, at baseline and at 1-year-follow-up(FU), after eradication-therapy(ET). METHODS: IBD diagnosis was based on Porto-criteria, and all patients underwent gastroscopy at baseline and 1-year FU. For Crohn's-disease(CD) and ulcerative colitis(UC), IBD-CAI and -ESS were classified using PCDAI/SES-CD and PUCAI/UCEIS, respectively. RESULTS: 76 IBD-patients were included in the study[35 F(46.1%),median-age 12(range 2-17)]. CD and UC were diagnosed in 29(38.2%) and 45(59.2%)patients, respectively, and unclassified-IBD in two(2.6%)patients. Non-IBD patients were 148[71 F(48.0%),median-age 12(range 1-17)]. Hp-infection at baseline was reported in 7(9.2%) and 18(12.2%)IBD and non-IBD patients, respectively(p = 0.5065). The 7 IBD patients with Hp infection were compared to 69 IBD patients without Hp-infection at baseline evaluation, and no significant differences were reported considering CAI and ESS in these two groups. At 1-year FU, after ET, IBD patients with Hp infection improved, both for CAI and ESS, but statistical significance was not reached. CONCLUSION: The occurrence of Hp-infection did not differ between IBD and no-IBD patients. No differences in CAI or ESS were observed at the diagnosis, and after ET no worsening of CAI or ESS was noted at one-year FU, between Hp-positive and -negative IBD patients.
背景：幽门螺杆菌（Hp）感染与儿科患者炎症性肠病（IBD）之间的关系仍存在争议。本研究旨在评估新诊断的 IBD 患儿与非 IBD 患儿之间 Hp 感染的发生率。此外，我们还旨在检查基线和 1 年随访（FU）时 IBD 患者中 Hp 感染与非 Hp 感染患者之间临床活动指数（CAI）和内镜严重程度评分（ESS）的差异，以及根除治疗（ET）后。
方法：IBD 诊断基于 Porto 标准，所有患者均在基线和 1 年 FU 时行胃镜检查。对于克罗恩病（CD）和溃疡性结肠炎（UC），使用 PCDAI/SES-CD 和 PUCAI/UCEIS 分别对 IBD-CAI 和 -ESS 进行分类。
结果：本研究纳入 76 例 IBD 患者[35 例女性（46.1%），中位年龄 12 岁（范围 2-17 岁）]。诊断为 CD 和 UC 的患者分别为 29 例（38.2%）和 45 例（59.2%），2 例（2.6%）患者为未分类 IBD。非 IBD 患者为 148 例[71 例女性（48.0%），中位年龄 12 岁（范围 1-17 岁）]。基线时 IBD 和非 IBD 患者中分别有 7 例（9.2%）和 18 例（12.2%）报告 Hp 感染（p=0.5065）。在基线评估时，将 7 例 Hp 感染的 IBD 患者与 69 例无 Hp 感染的 IBD 患者进行比较，两组之间 CAI 和 ESS 无显著差异。在 1 年 FU 时，接受 ET 后，Hp 感染的 IBD 患者的 CAI 和 ESS 均有所改善，但未达到统计学意义。
结论：IBD 患者与非 IBD 患者之间 Hp 感染的发生率无差异。在诊断时，CAI 或 ESS 无差异，在 1 年 FU 时，在 ET 后，Hp 阳性和阴性 IBD 患者之间，CAI 或 ESS 无恶化。
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