儿童腹型过敏性紫癜与幽门螺杆菌感染的关系探讨

Relationship between Helicobacter pylori infection and Henoch-Schonlein purpura with gastrointestinal involvement in children

目的探讨腹型过敏性紫癜(HSP)的发病及反复发作与幽门螺杆菌(HP)感染的关系。方法对36例腹型HSP及32例非腹型HSP中的16例进行胃、十二指肠内镜检查并行快速尿素酶试验,另设30例健康儿童作为对照组。3组均进行14C尿素呼气试验、血清抗HP抗体检测。结果36例腹型HSP患儿HP阳性21例(58.3%),其中反复发作16例,HP阳性13例(81.3%),首次发作20例HP阳性9例(45.0%)。32例非腹型HSP患儿HP阳性9例(28.1%);对照组HP阳性2例(6.7%)。三组比较差异具有非常显著性意义(χ2=14.7,P<0.01),反复发作与首次发作比较差异具有显著性意义(χ2=4.49,P<0.05)。结论腹型HSP的发病及反复发作与HP感染有关。

Objective To study the relationship of Helicobacter pylori （H. pylori ） infection with the development and relapse of Henoch-Schonlein purpura （HSP） with gastrointestinal involvement in children. Methods Thirty-six HSP children with gastrointestinal manifestations and 16 of 32 HSP children without gastrointestinal involvement underwent gastroscopy and rapid urease test for H. pylori detection. Thirty healthy children served as the control group. All of the patients received ^14 C urea breath test and serum H. pylori antibody detections. H. pylori infection was definited when two of detection approaches demonstrated positive. Results Twenty-one of 36 HSP patients with gastrointestinal manifestations were confirmed with H. pylori infection （58.3%）. Of them, the relapsed patients had an H. pylori positive rate of 81.3% （ 13/16）, which was significantly higher than that of the newly diagnosed patients （45.0% ,9/20） （ X^2 = 4.49, P 〈0.05 ）. Nine of 32 HSP patients without gastrointestinal manifestations were confirmed with H. pylori infection （28.1%） ; 2 of 30 healthy children showed H. pylori positive （6.7% ,2/30）. There was a significant difference in the H. pylori positive rate among the three groups （ X^2 = 14.7, P 〈 0.01 ）. Conclusions H. pylori infection may be associated with the development and relapse of HSP with gastrointestinal involvement in children.