上消化道疾病幽门螺杆菌感染对缺铁性贫血的影响

Effect of Helicobacter pylori infection on Iron Deficiency Anemia Among Upper Alimentary Diseases

目的 探讨儿童上消化道疾病幽门螺杆菌(Helicobacter Pylori, HP)感染率及HP感染对儿童缺铁性贫血(Iron Deficiency Anemia, IDA)的影响。方法 2000年6月至2004年6月本院住院及门诊335例患者上消化道疾病患儿,其中缺铁性贫血患儿109例;采用奥林巴斯GIF-V电子胃镜检查,并进行快速尿素酶试验,14C-呼气试验检测;随机选择HP感染阳性和阴性患儿各50例检测血清铁蛋白(SF)、血红蛋白(Hb)、平均红细胞体积(MCV)、红细胞分布宽度(RDW)。结果 胃镜检查检出HP感染61例,检出率占18.2%(61/335)。各年龄组胃十二指肠疾病HP感染率具有显著差异(P<0.05),HP感染与年龄呈显著正相关(r =0.749,P=0.003),随着年龄的增长,上消化道疾病的发生率逐渐升高(P<0.05),消化性溃疡的发生率也随年龄增长而增加(十二指肠溃疡:r=0.726;胃溃疡:r=0.703; P<0.05)。HP感染阳性组与阴性组比较SF、Hb、MCV、RDW差异均有显著性意义(P<0.05);感染HP儿童血清铁蛋白水平明显低于未感染HP儿童。结论 小儿HP感染随年龄增长而增加,HP感染儿童机体铁营养水平降低,是造成或加重儿童机体铁营养不良的独立危险因素,HP感染是IDA的原因之一,在治疗IDA的过程中应注意清除HP感染。

Objective To explore the morbidities of Helicobacter pylori(HP) infection of childrensupper alimentary diseases,and the relationship between Hp infection and Iron Deficiency Anemia(IDA).Methods 335 children of upper digestive tract disease were investigated with Olimpus electrongastroscope; 50 HP-positive were measured with hemoglobin(Hb),mean corpuscular volume(MCV),redblood cell distribution width index(RDW) with automatic Complete Blood Count; SF with an immunoradiometricassay. Results 335 cases had lesions under gastroscopy with 18.2%(61/335) HP positive. Significantdifference was found on HP infection rate among various groups(P<0.05). Furthermore,HP infectionwas positively correlated with the age. Positive correlation was found between the age and the upperalimental diseases (r=0.749, P<0.05).And peptic ulcer increased with age (duodenal bulb ulcer:r=0.726;gastric ulcer:r=0.703; P<0.05).Significant difference was found on SF,Hb, MCV, RDW among HP-positive and HP-negative(P<0.05).Mann-Whitney test and multivariate analysis of covariance bothshowed thaat SF concentration was significantly lower in Hp infected individuals than non-infectedindividuals.Conclusion It was found that the possibility of HP infection in gastric mucosaincreaseed with ascending of age in the affected children. Iron nutritional status was reduced inHP infected preschool children. HP infection appeafrs to be an independent risk factor or an addedstressor on iron status among children.