Patel P, Mendall M A, Khulusi S, Northfield T C, Strachan D P
Division of Biochemical Medicine, St George's Hospital Medical School, London.
BMJ. 1994 Oct 29;309(6962):1119-23. doi: 10.1136/bmj.309.6962.1119.
To investigate the current prevalence of Helicobacter pylori infection in childhood, the risk factors for infection, and the effect of infection on growth in preadolescent schoolchildren.
Population based sample of 7 year old schoolchildren followed up at age 11; data on risk factors for infection collected at age 7; presence of infection at age 11 determined by measurement of salivary IgG against H pylori by a newly developed enzyme linked immunosorbent assay (ELISA). Height was measured at 7 and 11 years of age.
554 schoolchildren from Edinburgh.
62 (11%) children had H pylori infection. Independent risk factors for infection were single parent families (adjusted odds ratio = 2.5; 95% confidence interval 1.1 to 5.7), the 10% most crowded homes (3.1; 1.3 to 7.2), and schools serving predominantly rented housing estates (2.5; 1.0 to 6.5). School catchment area was more important than parental social class or housing tenure. Growth in height between 7 and 11 was diminished in infected children by a mean of 1.1 cm (0.3 to 2.0 cm) over four years. This growth reduction was largely confined to girls (1.6 cm over four years), among whom it correlated with salivary IgG (P = 0.015).
Data from salivary assay to investigate the epidemiology of H pylori suggest that factors relating to the type of community in which the child lives may now be as important for acquisition of this infection as features of the family home. The greater reduction of growth among infected girls raises the possibility that H pylori infection may delay or diminish the pubertal growth spurt.
调查儿童幽门螺杆菌感染的当前患病率、感染的危险因素以及感染对青春期前学龄儿童生长的影响。
以7岁学龄儿童为基础的人群样本，随访至11岁；7岁时收集感染危险因素的数据；11岁时通过一种新开发的酶联免疫吸附测定法（ELISA）检测唾液中抗幽门螺杆菌IgG来确定是否感染。分别在7岁和11岁时测量身高。
来自爱丁堡的554名学龄儿童。
62名（11%）儿童感染幽门螺杆菌。感染的独立危险因素包括单亲家庭（校正比值比=2.5；95%置信区间1.1至5.7）、居住在最拥挤的10%家庭中（3.1；1.3至7.2）以及主要为租赁住宅区服务的学校（2.5；1.0至6.5）。学校招生区域比父母的社会阶层或住房保有情况更重要。感染儿童在7至11岁之间的身高增长在四年内平均减少了1.1厘米（0.3至2.0厘米）。这种生长减缓主要限于女孩（四年内减少1.6厘米），且与唾液IgG相关（P=0.015）。
唾液检测幽门螺杆菌流行病学的数据表明，与儿童居住社区类型相关的因素现在对于感染该病菌可能与家庭环境特征同样重要。感染女孩生长减缓更为明显，这增加了幽门螺杆菌感染可能延迟或减少青春期生长突增的可能性。
