儿童幽门螺杆菌感染与反复呼吸道感染的关系及对免疫功能的影响

Study on the relationship between Helicobacter pylori infection and recurrent respiratory tract infection and its effect on immune function in children

目的分析儿童幽门螺杆菌感染与反复呼吸道感染的关系及对免疫功能的影响。方法选择唐山市妇幼保健院自2019年5月-2020年12月接诊的876例反复呼吸道感染患儿作为观察组,另选同期的876名健康体检儿作为对照组。检测所有入组者血清免疫球蛋白、补体和外周血T淋巴细胞亚群水平,观察幽门螺杆菌感染发生情况,分析观察组中感染和未感染幽门螺杆菌患儿反复呼吸道感染缓解时间,比较观察组与对照组免疫球蛋白和T淋巴细胞亚群检测结果。结果观察组幽门螺杆菌感染发生率为26.03%,高于对照组的14.16%,差异有统计学意义(χ^(2)=38.453,P<0.001)。3~<6岁、6~<10岁及10~13岁的反复呼吸道感染患儿幽门螺杆菌感染发生率差异无统计学意义(χ^(2)=5.144,P=0.076)。反复呼吸道感染患儿均获得随访12个月,其中未感染幽门螺杆菌患儿反复呼吸道感染的平均缓解时间为(5.71±1.32)个月,短于感染幽门螺杆菌患儿(6.50±1.48)个月,差异有统计学意义(t=11.672,P<0.001)。两组血清IgG、IgA、IgM、C3、C4水平比较,差异无统计学意义(P均>0.05)。两组外周血CD3^(+)、CD4^(+)、CD8^(+)比较,差异无统计学意义(P均>0.05);观察组CD4^(+)/CD8^(+)比值小于对照组,差异有统计学意义(t=5.412,P=0.047)。结论儿童幽门螺杆菌感染与反复呼吸道感染的发生存在正性相关,与其加重患儿免疫功能紊乱有关。

Objective To study the relationship between Helicobacter pylori infection and recurrent respiratory tract infection and its effect on immune function in children.Methods A total of 876 children with recurrent respiratory tract infection who were admitted to Tangshan Maternal and Child Health Hospital in Hebei Province from May 2019 to December2020 were selected as the observation group,and 876 healthy children during the same period were selected as the control group.Serum immunoglobulin,complement and T lymphocyte subsets in peripheral blood were used to observe the occurrence of Helicobacter pylori infection.Analysis was used to analyze the remission time of repeated respiratory tract infections in children infected and uninfected with Helicobacter pylori in the observation group.The detection results of immunoglobulin and T lymphocyte subsets in the observation group and the control group.Results The incidence of Helicobacter pylori infection in the observation group was 26.03%,which was higher than 14.16%in the control group,and the difference was statistically significant(χ^(2)=38.453,P<0.001).There was no significant difference in the incidence of Helicobacter pylori infection among children aged 3-<6,6-<10 and 10-13 years old with recurrent respiratory tract infection(χ^(2)=5.144,P=0.076).All children with recurrent respiratory tract infection were followed up for 12 months.The average remission time of recurrent respiratory tract infection in children without Helicobacter pylori infection was(5.71±1.32)months,which was shorter than that in childred with Helicobacter pylori infection(6.50±1.48)month,and the difference was statistically significant(t=11.672,P<0.001).There were no significant differences in serum IgG,IgA,IgM,C3 and C4levels between the two groups(all P>0.05).There were no significant differences in peripheral blood CD3^(+),CD4^(+)and CD8^(+)between the two groups(all P>0.05).The ratio of CD4^(+)/CD8^(+)in observation group was lower than that in control group,and the difference was statistically significant(t=5.412,P=0.047).Conclusion Helicobacter pylori infection in children with recurrent respiratory tract infections had positive correlation,and its increase with immune dysfunction was worth further defined.