过敏性紫癜患儿链球菌与幽门螺杆菌及肺炎支原体感染临床特征及治疗结局

Analysis of clinical characteristics and treatment outcomes of Streptococcus, Helicobacter pylori and Mycoplasma pneumoniae in infections children patients with Henoch-Schonlein purpura

目的分析过敏性紫癜(HSP)患儿感染链球菌、幽门螺杆菌(Hp)及肺炎支原体(MP)临床特征及治疗结局。方法回顾性选取于襄阳市中心医院皮肤科治疗的136例HSP患儿的临床资料,分别根据血抗链球菌溶血素O(ASO)检查分为ASO阳性组及ASO阴性组,Hp检查分为Hp阳性组及Hp阴性组,MP检查分为MP阳性组及MP阴性组,分析上述病原菌感染与HSP患儿临床特征的关系;并将HSP患儿分为链球菌单一感染组、Hp单一感染组、MP单一感染组及混合感染组、阴性感染组,比较各组临床疗效及复发率。结果ASO阳性组年龄、关节肿痛及紫癜性肾炎发生率、IgA水平均高于ASO阴性组(P<0.05),C3、C4水平则低于ASO阴性组(P<0.05);Hp阳性组年龄、腹痛、消化道出血、紫癜性肾炎发生率、IgA水平均高于Hp阴性组(P<0.05),C3、C4水平则低于Hp阴性组(P<0.05);MP阳性组关节肿痛发生率及IgA水平高于MP阴性组(P<0.05),C3、C4水平则低于MP阴性组(P<0.05)。混合感染组临床疗效低于阴性感染组(P<0.05),复发率则高于阴性感染组(P<0.05)。结论链球菌、Hp及MP感染在儿童HSP发生发展中发挥重要作用,混合感染还可影响临床疗效及复发,定期监测病原微生物感染有其必要性。

OBJECTIVE To analyze the clinical characteristics and treatment outcomes of infections of Streptococcus,Helicobacter pylori(Hp)and Mycoplasma pneumoniae(MP)in children patients with Henoch-Schonlein purpura(HSP).METHODS The clinical data of 136 children patients with HSP in our hospital were retrospectively analyzed.The children patients were divided into ASO positive group and ASO negative group according to the blood antistreptolysin O(ASO)examination,and were divided into Hp positive group and Hp negative group according to Hp examination,and divided into MP positive group and MP negative group by MP examination.The relationship between the above-mentioned pathogen infections and clinical characteristics of children patients with HSP was analyzed.The children patients with HSP were divided into Streptococcal single infection group,Hp single infection group,MP single infection group,mixed infection group and negative infection group.The clinical efficacy and recurrence rate were compared among the groups.RESULTS The age,incidence rates of joint swelling and pain,anaphylactic purpura nephritis and level of IgA in ASO positive group were significantly higher than those in ASO negative group(P<0.05)while the levels of C3 and C4 were significantly lower than those in ASO negative group(P<0.05).The age,incidence rates of abdominal pain,gastrointestinal bleeding,anaphylactic purpura nephritis and level of IgA in Hp positive group were significantly higher than those in Hp negative group(P<0.05)while the levels of C3 and C4 were significantly lower than those in Hp negative group(P<0.05).The incidence rate of joint swelling and pain and level of IgA in MP positive group were significantly higher than those in MP negative group(P<0.05)while the levels of C3 and C4 were significantly lower than those in MP negative group(P<0.05).The clinical efficacy of mixed infection group was significantly lower than that of negative infection group(P<0.05)while the recurrence rate was significantly higher than that of negative control group(P<0.05).CONCLUSION Streptococcus,Hp and MP infections play an important role in the occurrence and development of HSP in children.Mixed infection can also affect the clinical efficacy and recurrence,thus it is necessary to perform regular monitoring of pathogenic microbial infections.