不同类型幽门螺杆菌感染与儿童过敏性紫癜发病风险、临床表型的关联性研究

Correlation between different types of Helicobacter pylori infection and attack risk as well as clinical phenotype in children with allergic purpura

  • 摘要: 目的 探讨不同类型幽门螺杆菌(Hp)感染与儿童过敏性紫癜(HSP)发病风险、临床表型的关系。 方法 选取江苏省南通市第二人民医院100例儿童过敏性紫癜患儿为病例组,选取同期体检的100例健康儿童作为对照组。比较2组儿童Hp感染率的变化,分析不同类型Hp感染对儿童过敏性紫癜临床表型的影响。 结果 病例组Hp阳性率为35.00%, 对照组为17.00%, 病例组Hp阳性率显著高于对照组(P<0.05); Hp阳性HSP患儿肾功能血清肌酐(Scr)、血尿素氮(BUN)显著高于Hp阴性者(P<0.05); Hp阳性者紫癜性肾炎标志物胱抑素C(CysC)、肿瘤标志物(TM)、血管性血友病因子(vWF)、可溶性血管细胞黏附分子-1(sVCAM-1)、结缔组织生长因子(CTGF)和基质金属蛋白酶9(MMP9)水平均显著高于Hp阴性者(P<0.05)。病例组中有35例Hp阳性者,其中Ⅰ型17例, Ⅱ型6例,中间型12例; 对照组中, Ⅰ型3例, Ⅱ型12例,中间型2例,病例组中Ⅰ型菌株感染率显著高于对照组(P<0.05); 有消化道症状或关节症状的患儿中, Ⅰ型菌株感染率显著高于无症状患儿(P<0.05)。 结论 HSP发病及其肾脏损害与Hp感染显著相关,且不同类型Hp感染的致病作用存在差异, Ⅰ型菌株感染与HSP发病以及关节和消化道损害均存在关联性。

     

    Abstract: Objective To explore the relationship between different types of Helicobacter pylori(Hp)infection and attack risk of developing Henoch-Schonlein purpura(HSP)in children as well as clinical phenotype. Methods A total of 100 HSP children treated in Nantong City Second People's Hospital were selected as case group, and another 100 healthy children who underwent physical examination in our hospital during the same period were selected as control group. The change of Hp infection rates in the two groups was compared, and the clinical effects of different types on clinical phenotypes of HSP were observed. Results Hp positive rate was 35.00% in the case group,and 17.00% in the control group, and was higher in the case group than that of the control group(P<0.05); the levels of serum creatinine(Scr)and blood urea nitrogen(BUN)in Hp positive HSP children were significantly higher than those in the Hp negative patients(P<0.05). Meanwhile, the levels of serum cystatin C(CysC), tumor marker(TM), von willebrand factor(vWF), soluble vascular cell adhesion molecule-1(sVCAM-1), connective tissue growth factor(CTGF)and matrix metalloproteinase(MMP9)were also significantly higher than those in the Hp negative patients(P<0.05). In the case group, there were 35 Hp-positive patients, including17 with type Ⅰ, 6 with type Ⅱ and 12 with intermediate type. In the control group, there were 3 cases with type Ⅰ, 12 with type Ⅱ and 2 with intermediate type. The infection rate of type Ⅰ strain in the case group was significantly higher than that in the control group(P<0.05); the infection rate of type Ⅰ strain in children with digestive tract - symptoms or joint symptoms was significantly higher than that of the asymptomatic group(P<0.05). Conclusion The occurrence of HSP is closely related to Hp infection, and the pathogenic factors of Hp infection of different types are greatly differed. Type Ⅰ infection is associated with attack of HSP joint and injury of digestive tract as well as joint.

     

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