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.
-
-
华冉, 鹿玲. 过敏性紫癜患儿血清低糖基化IgA1、核因子κB与炎症递质的研究[J]. 临床儿科杂志, 2016, 34(4): 268-272. 袁芳, 金燕樑. 儿童过敏性紫癜研究进展[J]. 临床儿科杂志, 2013, 31(3): 287-290. Teng X, Wang Y, Lin N, et al. Evaluation of serum procalcitonin and C-reactive protein levels as biomarkers of Henoch-Schönlein Purpura in pediatric patients[J]. Clin Rheumatol, 2016, 35(3): 667-671.
舒建义, 龙晓玲, 张泉山, 等. 幽门螺旋杆菌感染对过敏性紫癜患儿肾功能的影响[J]. 皖南医学院学报, 2016, 35(2): 148-150. Mytinger J R, Patterson J W, Thibault E S, et al. Henoch-Schönlein Purpura associated with Helicobacter pylori infection in a child[J]. Pediatr Dermatol, 2008, 25(6): 630-632.
袁雪菲, 韩娟, 邵迎春, 等. Hp抗体免疫印迹法分型对胃肠道疾病的诊断价值[J]. 医药前沿, 2016, 6(1): 188-189. Fidan K, Kandur Y, Ucar M, et al. Posterior reversible encephalopathy syndrome in henoch-schonlein Purpura and hemolytic uremic syndrome[J]. J Clin Med Res, 2016, 8(7): 544-547.
朱炎, 丁守梅, 杨丽, 等. 过敏性紫癜患儿感染病原菌分布与对T细胞亚群影响研究[J]. 中华医院感染学杂志, 2016, 26(8): 1880-1881 , 1886.
Gasbarrini A, Carloni E, Gasbarrini G, et al. Helicobacter pylori and extragastric diseases: other Helicobacters[J]. Helicobacter, 2004, 9(Suppl 1): 57-66.
张双红, 谢勇, 李弼民, 等. 胃十二指肠疾病儿童幽门螺杆菌cagA、vacA和iceA基因型分布[J]. 中国当代儿科杂志, 2016, 18(7): 618-624. 翟玉娥, 孙树凯, 马金龙, 等. 血清NGAL、CysC、Cr和BUN水平检测对高血压肾病的早期诊断价值[J]. 山东医药, 2016, 56(33): 63-65. Wijarnpreecha K, Thongprayoon C, Nissaisorakarn P, et al. Association of Helicobacter pylori with chronic kidney diseases: a meta-analysis[J]. Dig Dis Sci, 2017, 62(8): 2045-2052.
柳相珍, 张媛, 徐成伟, 等. 子痫前期患儿血浆中可溶性内皮细胞蛋白C受体与血管性血友病因子及可溶性血栓调节蛋白的水平变化[J]. 中华检验医学杂志, 2016, 39(10): 783-785. 李红蓉, 位庚, 孙颖, 等. 通络药物对血管内皮细胞与单核细胞黏附作用的影响[J]. 中国循环杂志, 2016, 31(5): 480-483. 焦颖华, 邢磊, 陈继贵. 解聚复肾宁对糖尿病肾病患者血清和尿液结缔组织生长因子的影响[J]. 中国老年学杂志, 2016, 36(6): 1333-1335. 岳会敏, 刘飞, 李范林, 等. 冬虫夏草菌丝体提取物调控免疫改善肾纤维化的实验研究[J]. 中国免疫学杂志, 2016, 32(3): 354-357. -
期刊类型引用(13)
1. 付中英，杨燕玲，苏月华，于晗澍，李曼，朱凤芹，常红. 过敏性紫癫患儿外周血单个核细胞中ASC mRNA和NLRP3 mRNA表达水平及其与并发肾炎的关系. 中国妇幼健康研究. 2024(11): 20-31 . 
百度学术
2. 刘阳，郝佳，卑雪，赵志佳，李阳. 过敏性紫癜患儿幽门螺杆菌感染及其对补体系统及炎症指标的影响. 中华医院感染学杂志. 2023(01): 138-141 . 百度学术
3. 郭爱玲. 学龄前期HP阳性儿童的免疫功能及生长发育的特点. 哈尔滨医药. 2023(01): 33-35 . 百度学术
4. 潘馨，刘佳奕，王艳，童敏，严方利，孙香娟. 幽门螺杆菌感染与儿童过敏性紫癜相关性的Meta分析. 医学信息. 2023(02): 92-98 . 百度学术
5. 黄丽琴，江秀华. 微生态制剂结合抗Hp三联方案治疗Hp阳性腹型AP患儿的效果. 数理医药学杂志. 2022(06): 893-895 . 百度学术
6. 孙文，黄雅玲，高健. 腹型过敏性紫癜患儿幽门螺杆菌感染与消化道出血的关系及相关因素探讨. 现代消化及介入诊疗. 2022(03): 355-358 . 百度学术
7. 王彩芳，么鑫，蔡花，张菂，黄翠影，梁晓亮，陈瑞珊，海冬. 肺炎链球菌、肺炎支原体、柯萨奇病毒及EB病毒感染与儿童过敏性紫癜肾炎的相关性研究. 临床和实验医学杂志. 2022(19): 2099-2103 . 百度学术
8. 刘力铭，张颖，赵子年，杨金玉，焦丽华，刘建丽，回广飞. 过敏性紫癜患儿呼吸道病毒感染特异性免疫球蛋白M检测及血清炎性因子变化. 临床军医杂志. 2021(07): 768-769 . 百度学术
9. 王杨. 过敏性紫癜患儿血清中Cys C、TM与T淋巴细胞亚群的关系及易感因素分析. 中国医学创新. 2021(21): 10-14 . 百度学术
10. 王士杰，胡方起，和平，余必信，邓芳. 黄芪颗粒联合氢化可的松琥珀酸钠治疗过敏性紫癜临床疗效与安全性探究. 中华中医药学刊. 2021(09): 169-172 . 百度学术
11. 王婧，韩磊，张震，夏毓，姜烜星，汤兴萍. 儿童过敏性紫癜感染幽门螺杆菌的危险因素分析与治疗研究. 系统医学. 2021(16): 31-34 . 百度学术
12. 李丹，张波，秦帅，刘宇. 微生态制剂结合抗幽门螺杆菌三联方案治疗儿童幽门螺杆菌阳性腹型过敏性紫癜的疗效分析. 中国现代医学杂志. 2021(19): 44-48 . 百度学术
13. 郭志伟. 探究儿童过敏性紫癜临床用药的治疗效果. 中国继续医学教育. 2021(30): 156-159 . 百度学术
其他类型引用(1)
计量
- 文章访问数: 376
- HTML全文浏览量: 98
- PDF下载量: 10
- 被引次数: 14
下载:
苏公网安备 32100302010246号