Perri F, Pastore M, Clemente R, Festa V, Quitadamo M, Niro G, Conoscitore P, Rutgeerts P, Andriulli A
Division of Gastroenterology, Casa Sollievo della Sofferenza Hospital, I.R.C.C.S., San Giovanni Rotondo, Italy.
J Pediatr Gastroenterol Nutr. 1998 Aug;27(2):181-3. doi: 10.1097/00005176-199808000-00010.
Helicobacter pylori infection is generally acquired early in life. However, it is still unknown whether a spontaneous eradication can occur. The purpose of this study was to evaluate whether H. pylori infection can undergo spontaneous eradication in children.
Three hundred and four Italian children (age range, 4.5 to 18.5 years) were tested for H. pylori by means of 13C-urea breath test. Infected children were followed up every 6 months for as long as 2 years. Parents were instructed to record consumption of antibiotics. At each visit, children underwent a repeat 13C-urea breath test.
Eighty-five out of 304 (27.9%) children were H. pylori infected. Forty-eight out of 85 infected children (56.4%) participated in the follow-up study. After 2 years, 8 (16.6%) infected children had negative results on 13C-urea breath tests; 2 of them were given antibiotics for concomitant infections. One child was negative at 6 months but became positive again at the next 6-month 13C-urea breath test. Forty children remained persistently positive; of them, 10 were treated with a short course of antibiotics.
Our findings support the hypothesis that, at least during childhood, H. pylori infection may be a fluctuating disease with spontaneous eradication and possible recurrence.
幽门螺杆菌感染通常在生命早期获得。然而，目前仍不清楚是否会发生自然清除。本研究的目的是评估幽门螺杆菌感染在儿童中是否会自然清除。
对304名意大利儿童（年龄范围4.5至18.5岁）进行了13C尿素呼气试验以检测幽门螺杆菌。对感染儿童每6个月进行一次随访，最长随访2年。指导家长记录抗生素的使用情况。每次随访时，儿童都要重复进行13C尿素呼气试验。
304名儿童中有85名（27.9%）感染了幽门螺杆菌。85名感染儿童中有48名（56.4%）参与了随访研究。2年后，8名（16.6%）感染儿童的13C尿素呼气试验结果为阴性；其中2名因合并感染接受了抗生素治疗。1名儿童在6个月时结果为阴性，但在下一次6个月的13C尿素呼气试验中再次转为阳性。40名儿童持续呈阳性；其中10名接受了短期抗生素治疗。
我们的研究结果支持这样的假设，即至少在儿童期，幽门螺杆菌感染可能是一种具有自然清除和可能复发的波动性疾病。
