Dale A, Thomas J E, Darboe M K, Coward W A, Harding M, Weaver L T
Department of Child Health, University of Newcastle-upon-Tyne, United Kingdom.
J Pediatr Gastroenterol Nutr. 1998 Apr;26(4):393-7. doi: 10.1097/00005176-199804000-00006.
Helicobacter pylori infection is very common in Gambian infants and children, who are also at risk of chronic diarrhoea and undernutrition. Acute H. pylori infection is associated with depressed gastric acid secretion, and loss of the gastric acid barrier may predispose to enteric infections.
In a prospective study a noninvasive test of gastric acid output (measurement of change in urine acid output before and after a feed) was performed on a population of Gambian infants at high risk of H. pylori infection. The 13C urea breath tests was used to measure the prevalence of H. pylori infection and growth was measured by serial anthropometry.
In 101 infants aged 3 to 12 months, there was a significant relation between H. pylori infection and depressed urine acid output in those aged 6 months, during weaning when growth failure and malnutrition begin. Those infants with sustained H. pylori infection grew less well than those without.
We speculate that H. pylori, acquired in infancy, could be a "key that opens the door" to enteric infection in childhood, leading to recurrent diarrhoea, malnutrition, and growth failure.
幽门螺杆菌感染在冈比亚婴幼儿中非常普遍，这些婴幼儿还面临慢性腹泻和营养不良的风险。急性幽门螺杆菌感染与胃酸分泌减少有关，胃酸屏障的丧失可能易引发肠道感染。
在一项前瞻性研究中，对一群有高幽门螺杆菌感染风险的冈比亚婴幼儿进行了一项非侵入性胃酸分泌测试（测量喂食前后尿液酸分泌的变化）。采用¹³C尿素呼气试验来测量幽门螺杆菌感染的患病率，并通过连续人体测量来衡量生长情况。
在101名3至12个月大的婴儿中，6个月大、处于断奶期（此时开始出现生长发育不良和营养不良）的婴儿，幽门螺杆菌感染与尿液酸分泌减少之间存在显著关联。那些持续感染幽门螺杆菌的婴儿比未感染的婴儿生长得更差。
我们推测，婴儿期感染的幽门螺杆菌可能是儿童期肠道感染的“开门钥匙”，导致反复腹泻、营养不良和生长发育不良。
