胃癌高发区儿童幽门螺杆菌感染及传播途径

Infection ofHelicobacter pyloriin children and mode of transmission in a highrisk area of gastric cancer

目的研究胃癌高发区儿童幽门螺杆菌（Ｈｐ）和ｃａｇＡ＋亚型感染状况及细菌传播方式，探讨儿童早期感染Ｈｐ与胃癌的关系．方法用１３Ｃ尿毒酶呼吸实验（１３ＣＵＢＴ）方法检测（山东省临朐县）９８名儿童Ｈｐ感染状况，用ＥＬＩＳＡ方法检测７０名儿童抗ＣａｇＡ抗体及成人抗Ｈｐ抗体．结果胃癌高发区儿童Ｈｐ感染率为６９４％，其中３岁～４岁儿童Ｈｐ感染率为５２６％．９岁～１０岁上升为８５％，１１岁～１２岁下降为６６７％，接近于成人水平．儿童ｃａｇＡ＋亚型感染率为７１４％．Ｈｐ感染有明显的家族聚集性，其中父母双方或一方Ｈｐ感染阳性的子女Ｈｐ感染率（８５％）明显高于父母Ｈｐ感染均阴性者（２２％，Ｐ＜００５）．结论胃癌高发区儿童Ｈｐ、特别是ｃａｇＡ＋亚型感染率很高，且有家族聚集性，表明儿童阶段即可感染Ｈｐ，并且与当地胃癌高发有明显关系．

IM To determine the prevalence of Helicobacter pylori(Hp) and cagA+ strain infection in children, investigate the mode of transmission and evaluate whether infection of Hp is associated with gastric cancer. METHODS We examined Hp infection (n=98) in children from Linqu County, Shandong Province, with 13CUrea breath test (13CUBT), IgG and IgA to antiHp in adults and IgG to CagA antigen in children (n=70) with ELISA. RESULTS Among 98 children, 68(694%) were Hp positive, but the prevalence rates varied in age rising from about 526% (3-4 years) to 85% (9-10 years) before falling to 667% (11-12 years). The prevalence rates of cagA+ were 714%, and Hp infection clustered within families. In families with at least one infected parent, 85% of children were Hp positive, while in families with both parents uninfected only 22% of children were Hp positive (85% vs 22%, P<005)CONCLUSION The prevalence rate of Hp and cagA+ strain is high in children at a high risk area of gastric cancer, and Hp infection clustered within families, suggesting that acquisition of Hp infection during early childhood is significantly related with this high risk area of gastric cancer.