Klein P D, Gilman R H, Leon-Barua R, Diaz F, Smith E O, Graham D Y
USDA/ARS Children's Nutrition Research Center, Department of Pediatrics and Medicine, Baylor College of Medicine, Houston, Texas.
Am J Gastroenterol. 1994 Dec;89(12):2196-200.
Cross-sectional studies of children in developing countries show a high prevalence of Helicobacter pylori infection at 6 months of age, but a decrease in the prevalence of infection between 1 and 5 yr of age. The decrease suggests a loss or clearance of infection, an uncommon finding in adults. Our objective in this study was to determine the longitudinal persistence of H. pylori infection in young children.
We tested an initial cohort of 105 6-month-old infants at 6-month intervals with the 13C-urea breath test; 56 subjects were successfully studied for 2 yr or until 30 months of age.
Overall prevalence decreased from 71.4% to 47.9% when children were between 6 and 18 months of age, and we found a significant gender difference (males 63.6-55.0%, females 80.0-38.7%, p = 0.03). Of the 56 subjects, six had negative breath tests at all 6-month intervals, 10 were consistently positive, and 36 subjects had one or more negative tests after a positive test. The overall probability of acquiring H. pylori in a given 6-month period ranged between 0.28 and 0.38; the probability of clearing the infection was between 0.22 and 0.45. During the first 18 months after birth, male infants were more likely to acquire H. pylori and less likely to clear the infection than female infants.
We conclude that H. pylori colonization in infants may be a reversible process.
对发展中国家儿童进行的横断面研究显示，6个月大的儿童幽门螺杆菌感染率很高，但1至5岁之间感染率有所下降。这种下降表明感染有所减少或清除，这在成年人中并不常见。我们这项研究的目的是确定幼儿幽门螺杆菌感染的纵向持续情况。
我们对105名6个月大的婴儿组成的初始队列每隔6个月进行一次13C尿素呼气试验；56名受试者成功接受了2年的研究或直至30个月大。
当儿童在6至18个月大时，总体感染率从71.4%降至47.9%，我们发现存在显著的性别差异（男性63.6%至55.0%，女性80.0%至38.7%，p = 0.03）。在56名受试者中，6人在所有6个月间隔的呼气试验中均为阴性，10人始终为阳性，36名受试者在一次阳性试验后有一次或多次阴性试验。在给定的6个月期间感染幽门螺杆菌的总体概率在0.28至0.38之间；清除感染的概率在0.22至0.45之间。在出生后的前18个月，男婴比女婴更易感染幽门螺杆菌且清除感染的可能性更小。
我们得出结论，婴儿幽门螺杆菌定植可能是一个可逆过程。
