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张强,田文朋.腹型过敏性紫癜发生消化道出血患儿HP感染及免疫反应分析.[J].中南医学科学杂志.,2021,(6):644-647.

腹型过敏性紫癜发生消化道出血患儿HP感染及免疫反应分析

Analysis of Helicobacter pylori infection and immune response in children with abdominal anaphylactoid purpura

投稿时间：2020-12-30 修订日期：2021-02-23

DOI：10.15972/j.cnki.43-1509/r.2021.06.006

英文关键词:abdominal allergic purpura gastrointestinal bleeding Helicobacter pylori immune function

基金项目:山东省医药卫生科技发展计划项目(2019WS527) 作者简介:张强,主治医师,研究方向为消化系统疾病的诊治,E-mail为chilu695368@163.com。

作者	单位
张强	山东省立第三医院消化内科,山东省济南市250031
田文朋	青岛市市立医院儿科,山东省青岛市266000

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中文摘要:

目的探究腹型过敏性紫癜(AHSP)发生消化道出血患儿幽门螺杆菌(HP)感染情况及免疫功能分析。方法选取AHSP患儿80例,按照是否消化道出血分为出血组(n＝33)和非出血组(n＝47),另选择同期40例健康小儿为健康组,比较3组HP感染情况及HP分型、肠道菌群、炎症细胞因子、免疫球蛋白、T淋巴细胞亚群水平。结果出血组HP阳性率高于非出血组和健康组,且Ⅰ型HP检出率高于Ⅱ型HP(P＜0.05)。出血组和非出血组乳酸杆菌、双歧杆菌水平低于健康组,大肠杆菌水平高于健康组,且出血组较非出血组更为显著(P＜0.05)。出血组和非出血组血清炎症细胞因子水平均高于健康组,且出血组较非出血组更高(P＜0.05)。出血组IgA、IgG、IgM水平低于非出血组和健康组(P＜0.05),非出血组IgA水平低于健康组(P＜0.05)。出血组和非出血组T淋巴细胞亚群CD3⁺、CD4⁺、CD4⁺/CD8⁺低于健康组,CD8⁺高于健康组,且出血组较非出血组更为显著(P＜0.05)。结论AHSP消化道出血的发病与HP感染、免疫功能紊乱有关,通过HP及免疫指标检测有助于AHSP并发消化道出血的预防和治疗。

英文摘要:

To explore the Helicobacter pylori (HP) infection and immune function analysis in children with gastrointestinal bleeding in abdominal allergic purpura (AHSP). MethodsA total of 80 children with AHSP were selected and divided into bleeding group (n＝33) and non-bleeding group (n＝47) according to whether or not they had gastrointestinal bleeding. In addition, 40 healthy children in the same period were selected as the healthy group. Three groups of HP infection and HP typing, intestinal flora, inflammatory cytokines, immunoglobulin, and T lymphocyte subgroup levels were compared. ResultsThe positive rate of HP in the bleeding group was higher than that in the non-bleeding group and the healthy group, and the detection rate of type I HP was higher than that of type II HP (P＜0.05). The levels of lactobacilli and bifidobacteria in the bleeding group and the non-bleeding group were lower than those in the healthy group, and the E.coli level was higher than that in the healthy group, and the bleeding group was more significant than the non-bleeding group (P＜0.05). The levels of serum inflammatory cytokines in the bleeding group and the non-bleeding group were higher than those in the healthy group, and the bleeding group was higher than the non-bleeding group (P＜0.05). The levels of IgA, IgG, and IgM in the bleeding group were lower than those in the non-bleeding group and the healthy group (P＜0.05), and the IgA levels in the non-bleeding group were lower than those in the healthy group (P＜0.05). The T lymphocyte subsets CD3⁺, CD4⁺, CD4⁺/CD8⁺ of the bleeding group and non-bleeding group were lower than the healthy group, and CD8⁺ was higher than that of the healthy group; the bleeding group was more significant than the non-bleeding group (P＜0.05). ConclusionThe onset of AHSP gastrointestinal bleeding is related to HP infection and immune dysfunction. The detection of HP and immune indicators is helpful to the prevention and treatment of AHSP with gastrointestinal bleeding.

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