de'Angelis G L, Apollionio G, Boselli E, De Fanti A, De Luca F, Fulgido S, Romanini E, Vanelli M
Service de Pédiatrie de l'Université de Parme, Italie.
Arch Fr Pediatr. 1993 Jun-Jul;50(6):475-8.
Adult patients with insulin-dependent diabetes mellitus frequently also show gastric disturbances. Knowledge of the prevalence of such abnormalities in children with insulin-dependent diabetes and the predictive value of anti-gastric parietal cell antibodies in blood may be of practical importance.
68 patients (29 boys and 39 girls), aged from 5 yr 2 mo to 19 yr 10 mo, and treated for insulin-dependent diabetes from 1 mo to 14 yr 6 mo, were included in the study. Fasting blood concentrations of gastrin (G), pepsinogen (PG1), anti-gastric parietal cell antibodies (PCA) were measured. Fiberoptic endoscopy and biopsy of the gastroduodenal mucosa were performed in PCA+ patients and biopsy samples were examined for Helicobacter pylori (HP).
12 patients were PCA+; 3 of them had blood gastrin levels above 104 pg/ml and 4 had blood pepsinogen levels 24 ng/ml. Histologically, 3 patients had chronic diffuse gastritis (2 were HP+); 2 had chronic gastritis restricted to the antro-pyloric area (both were HP+); 3 had follicular lymphoid hyperplasia (without HP) and 4 had normal mucosa (without HP).
The presence of PCA can predict the risk of chronic gastritis, possibly auto-immune in origin, in children with insulin-dependent diabetes.
胰岛素依赖型糖尿病成年患者常伴有胃部功能紊乱。了解胰岛素依赖型糖尿病儿童此类异常情况的患病率以及血液中抗胃壁细胞抗体的预测价值可能具有实际意义。
本研究纳入68例患者(29例男孩和39例女孩),年龄从5岁2个月至19岁10个月,胰岛素依赖型糖尿病病程从1个月至14年6个月。检测空腹血胃泌素(G)、胃蛋白酶原(PG1)、抗胃壁细胞抗体(PCA)浓度。对PCA阳性患者进行纤维胃镜检查及胃十二指肠黏膜活检,活检样本检测幽门螺杆菌(HP)。
12例患者PCA阳性;其中3例血胃泌素水平高于104 pg/ml,4例血胃蛋白酶原水平高于24 ng/ml。组织学检查,3例患者有慢性弥漫性胃炎(2例HP阳性);2例有局限于胃窦 - 幽门区的慢性胃炎(均为HP阳性);3例有滤泡性淋巴样增生(无HP),4例黏膜正常(无HP)。
PCA阳性可预测胰岛素依赖型糖尿病儿童发生可能源于自身免疫的慢性胃炎的风险。