Helicobacter：幽门螺杆菌影响铁储备和缺乏

　　作为幽门螺杆菌再感染的二次分析，研究者研究了幽门螺杆菌感染与其清除血清铁蛋白及造成铁缺乏的效应之间的相关性。

　　来自美国阿拉斯加州的Karen Miernyk医生对行上消化道内镜检查的阿拉斯加当地成年人采集血清，并进行13C尿素呼气试验检查。

　　对幽门螺杆菌阳性者给予联合抗生素治疗。

　　在治疗2个月后转阴者需在第4，6，12，24个月进行尿素呼气试验评价，并用免疫放射分析法测定血清铁蛋白水平。

　　研究者在进一步的分析中将被开有补充铁剂医嘱的人排除。

　　研究团队测量了241人的血清铁蛋白，241人中121人为幽门螺杆菌阳性。

　　幽门螺杆菌感染有和无者血清铁蛋白的几何均数分别为37μg/L和50μg/L。

　　在调查中，121名幽门螺杆菌阳性者中有19个发生铁缺乏；相对的，120名幽门螺杆菌阴性者中有8个发生铁缺乏。

　　研究者发现在第24个月进行尿素呼气试验的66名参与者，其铁蛋白的几何均数相比调查初始时升高。

　　在调查初始存在铁缺乏的11人中的6名，在24个月的治疗后，未再出现铁缺乏，且铁蛋白的几何均数升高。

　　Miernyk医生的团队观点为：“幽门螺杆菌感染与低血清铁蛋白水平及铁缺乏相关”。

　　“对于发生难以解释的铁缺乏的患者，需考虑到幽门螺杆菌的测试和随后对阳性者的治疗”。

The Effect of Helicobacter pylori Infection on Iron Stores and Iron Deficiency in Urban Alaska Native Adults
Background
Helicobacter pylori (H. pylori) infection has been correlated with low serum ferritin and iron deficiency. As a secondary analysis of a study of H. pylori reinfection, we investigated the association of H. pylori infection and the effect of its eradication on serum ferritin and iron deficiency.
Methods
Alaska Native adults undergoing esophagogastroduodenoscopy had sera collected and a 13C urea breath test (UBT) was performed. Those H. pylori positive were treated with an antibiotic regimen; those who tested negative 2 months after treatment were evaluated at 4, 6, 12, and 24 months by UBT and serum ferritin with an immunoradiometric assay. We excluded persons from further analysis if they were prescribed iron by their provider.
Results
We measured serum ferritin for 241 persons; 121/241 were H. pylori positive. The geometric mean ferritin (GMF) for persons with and without H. pylori infection was 37 μg/L and 50 μg/L, respectively (p = .04). At enrollment, 19/121 H. pylori-positive persons had iron deficiency compared with 8/120 H. pylori negative (p = .02). Among 66 persons tested at 24 months, the GMF was higher at 24 months (49.6 μg/L) versus enrollment (36.5 μg/L; p = .02). Six of 11 persons with iron deficiency at enrollment no longer had iron deficiency and had a higher GMF (p = .02) 24 months after treatment.
Conclusions
H. pylori infection was correlated with lower serum ferritin and iron deficiency. After H. pylori eradication, serum ferritin increased and approximately half of persons resolved their iron deficiency. Testing for H. pylori infection and subsequent treatment of those positive could be considered in persons with unexplained iron deficiency.