5. 初诊为儿童炎症性肠病的患者的幽门螺杆菌相关性胃炎的发病情况
Helicobacter. 2014 Oct;19(5):400-5. doi: 10.1111/hel.12141. Epub 2014 May 14.
The prevalence of Helicobacter pylori gastritis in newly diagnosed children with inflammatory bowel disease.
Roka K1, Roubani A, Stefanaki K, Panayotou I, Roma E, Chouliaras G.
背景：
最近的研究显示，炎症性肠病（IBD）的患者幽门螺旋杆菌感染率较低。该研究旨在比较希腊初诊IBD的儿童与未患有IBD的儿童的幽门螺杆菌（+/-）胃炎的发病情况。
材料和方法：
该回顾性研究对象为2002-2011年间初次行消化内镜检查的儿童。研究对象分为四组：克罗恩病患者（CD），溃疡性结肠炎（UC），未分类炎症性肠病患儿（IBDU）及非炎症性肠病患儿（non-IBD）。通过培养阳性或组织学阳性及CLO试验明确幽门螺杆菌诊断。对于培养阴性或未能培养的及仅一个方法阳性（组织学或CLO）的患儿进一步行尿素呼气试验以评估，阳性者纳入感染组。
结果：
我们研究了159 名IBD患者(66 CD, 34 UC, and 59 IBDU) 及1209名非IBD患者。幽门螺杆菌相关胃炎在IBD组发病率较低(IBD组3.8% vs 对照组13.2% ，p < .001)， IBD患儿年纪显著大于非IBD儿童(p < .001)。幽门螺杆菌阴性胃炎患儿属于IBD组的可能性是幽门螺杆菌阳性胃炎患儿的3.3倍(p = .006)。
结论：
IBD患儿组幽门螺杆菌胃炎的发生低于对照组。我们的研究证实幽门螺杆菌感染和IBD的负相关性。我们需要进一步辨别到底幽门螺杆菌的保护作用还是IBD患童既往抗生素的使用产生的效果。
译者小结：与大部分研究结果类似，儿童幽门螺杆菌感染与IBD呈负相关。
Abstract
BACKGROUND:
Recent studies have shown that patients with inflammatory bowel disease (IBD) are less likely to be infected with Helicobacter pylori compared with non-IBD patients. We aimed to study the prevalence of H. pylori-positive and H. pylori-negative gastritis in newly diagnosed children with IBD in comparison to those with non-IBD in Greece.
MATERIALS AND METHODS:
All children who underwent first esophagogastroduodenal endoscopy between 2002 and 2011 were retrospectively included. Four groups were studied: patients with Crohn's disease (CD), ulcerative colitis (UC), IBD unclassified (IBDU), and non-IBD individuals (non-IBD). Helicobacter pylori infection was defined by positive culture or by positive histology and CLO test. Those children with negative or not available culture and only one positive test (histology or CLO) were further evaluated by urea breath test, and the positives were also included in the infected group.
RESULTS:
We studied 159 patients with IBD (66 CD, 34 UC, and 59 IBDU) and 1209 patients in non-IBD individuals. Helicobacter pylori gastritis was less frequent in the IBD group (3.8% vs 13.2% in the control group, p < .001), whereas IBD patients were significantly older than non-IBD children (p < .001). Children with H. pylori-negative gastritis were 3.3 times more likely to belong in the IBD group compared with H. pylori-positive patients (p = .006).
CONCLUSIONS:
Occurrence of H. pylori gastritis is less frequent in children with IBD compared with controls. Our study confirms an inverse association between H. pylori and IBD. Future studies are needed to distinguish between a true protective role of H. pylori and a confounding effect due to previous antibiotic use in children with IBD.