腹型过敏性紫癜患儿Hp感染消化道出血和脏器损害症状分布及其相关影响因素分析

doi:10.3969/j.issn.1006-6233.2023.11.023

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摘要 目的: 分析腹型过敏性紫癜(HSP)患儿幽门螺杆菌(Hp)感染、消化道出血和脏器损害症状分布以及相关影响因素。方法: 选取我院2018年7月至2021年7月入院治疗的145例腹型HSP患儿作为研究对象,根据患儿消化道是否出血分为消化道出血组(68例)和非消化道出血组(77例)。比较两组患儿肠道菌群、炎症因子、辅助检查指标、免疫功能、脏器损害损伤、关节症状,进行Logistic回归分析腹型HSP是否是发生消化道出血的影响因素。结果: 两组患儿中性粒细胞百分比(N%)、血红蛋白(Hb)、嗜酸性粒细胞百分比(E%)、血小板(PLT)计数、PLT体积、红细胞沉降率、D二聚体异常、胸腹部B超阳性、胸腹片阳性、细胞间粘附分子(1ICAM1)、心脏病变比例比较相当,差异无统计学意义(P>0.05),消化道出血组患儿乳酸杆菌、淋巴细胞的百分比(L%)、免疫球蛋白A(IgA)、IgG、IgM、CD3⁺、CD4⁺低于非消化道出血组,差异有统计学意义(P<0.05),消化道出血组患儿大肠杆菌、血清白介素-6(IL-6)、IL-8、肿瘤坏死因子-α(TNF-α)水平、白细胞(WBC)计数、CD8⁺、肾脏病变、多脏器受累、关节症状比例较非消化道出血组更高,差异有统计学意义(P<0.05),Logistic回归分析结果显示:TNF-α、IgA、IgM、肾脏病变是腹型HSP患儿发生消化道的影响因素(P<0.05)。结论: 腹型HSP消化道出血患儿较非消化道出血患儿肠道有益菌减少,有害菌增加,免疫功能降低,炎症反应程度更高,肾脏病变比例更高,TNF-α、IgA、IgM、肾脏病变是腹型HSP消化道出血的影响因素。

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	吴坤卫
	李敏
	吴奇发

关键词 ：腹型过敏性紫癜, 幽门螺杆菌, 消化道出血, 肾脏病变, 免疫功能, 炎症因子

Abstract：Objective: To analyze the distribution of Helicobacter pylori (Hp) infection,gastrointestinal bleeding and organ damage in children with abdominal allergic purpura (HSP). Methods: A total of 145 children diagnosed with abdominal HSP,admitted to our hospital from July 2018 to July 2021,were included in the study.They were divided into two groups:the gastrointestinal bleeding group (68 cases) and the non-gastrointestinal bleeding group (77 cases).Various parameters,including intestinal flora,inflammatory factors,auxiliary examination results,immune function,organ damage,and joint symptoms,were compared between the two groups.Logistic regression analysis was performed to assess whether abdominal HSP is an influencing factor for the occurrence of gastrointestinal bleeding. Results: Among the two groups of children,parameters such as the percentage of neutrophils (N%),hemoglobin (Hb),eosinophils (E%),platelet (PLT) count,PLT volume,erythrocyte sedimentation rate,D-dimer abnormality,chest and abdominal B-ultrasound and x-ray findings,intercellular adhesion molecule (ICAM1),and the proportion of cardiac lesions were similar and showed no statistically significant differences (P>0.05).Children in the gastrointestinal bleeding group had lower levels of Lactobacillus,lymphocytes (L%),immunoglobulin A (IgA),IgG,IgM,CD3⁺,and CD4⁺ compared to the non-gastrointestinal bleeding group,with statistically significant differences (P<0.05).Additionally,the gastrointestinal bleeding group had higher levels of Escherichia coli,serum interleukin-6 (IL-6),IL-8,tumor necrosis factor-α (TNF-α),white blood cell (WBC) count,CD8⁺,renal lesions,multiple organ involvement,and joint symptoms compared to the non-gastrointestinal bleeding group,with statistically significant differences (P<0.05).Logistic regression analysis revealed that TNF-α,IgA,IgM,and renal lesions were influencing factors for gastrointestinal bleeding in children with abdominal HSP (P<0.05). Conclusion: Children with gastrointestinal bleeding in abdominal HSP had lower levels of beneficial intestinal bacteria,higher levels of harmful bacteria,compromised immune function,greater inflammatory responses,and a higher proportion of renal lesions compared to those without gastrointestinal bleeding.The influencing factors for gastrointestinal bleeding in abdominal HSP included TNF-α,IgA,IgM,and renal lesions.

Key words： Abdominal anaphylactic purpura Helicobacter pylori Gastrointestinal bleeding Renal disease Immune function Inflammatory factors

基金资助:海南省卫生健康行业科研项目,(编号:20A200330)

引用本文:

吴坤卫, 李敏, 吴奇发. 腹型过敏性紫癜患儿Hp感染消化道出血和脏器损害症状分布及其相关影响因素分析[J]. 河北医学, 2023, 29(11): 1876-1882.
WU Kunwei, LI Min, et al. Analysis of the Distribution of Digestive Tract Bleeding and Organ Damage Symptoms Associated with HP Infection in Children with Abdominal-Type Allergic Henoch-Schonlein Purpura and Their Related Influencing Factors. HeBei Med, 2023, 29(11): 1876-1882.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.11.023 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I11/1876

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