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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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

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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[J]. HeBei Med, 2023, 29(11): 1876-1882.

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

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