幽门螺杆菌感染与儿童过敏性紫癜早期肾损害的相关性研究

Association between Helicobacter pylori infection and early renal damage in children with Henoch-Schonlein purpura

目的探讨幽门螺杆菌(Hp)感染与儿童过敏性紫癜(HSP)的相关性及其对患儿早期肾损害的影响.方法选取151例HSP患儿作为研究对象,将其中合并Hp感染的52例HSP患儿随机分为A组与B组,A组在常规治疗基础上加施Hp根除治疗,B组采用常规治疗,另将未合并Hp感染的99例HSP患儿设为C组,采用常规治疗.3组患儿在初诊、病程1个月、病程3个月、病程6个月时均行尿微量蛋白检查,包括尿β2微球蛋白(β2-MG)、尿α1微球蛋白(α1-MG)、尿微量转铁蛋白(TRF)、尿白蛋白(UAlb)、尿免疫球蛋白G(UIgG).对3组患儿不同病程阶段的检查结果进行比较分析.结果151例HSP患儿中共52例检出Hp阳性,检出率为34.44%;B组的早期肾功能损害率高于C组,差异有统计学意义(P<0.05);病程3个月时,B组的α1-MG水平高于A组、C组,且B组的UAlb水平高于C组,差异有统计学意义(P<0.05);病程6个月时,B组β2-MG水平高于A组、C组,差异有统计学意义(P<0.05).结论合并Hp感染的HSP患儿较未合并Hp感染者更易出现肾损害,Hp根除治疗可降低肾损害发生率.HSP患儿肾损害早期以单独肾小球或肾小球、肾小管均受累为主,且尿微量蛋白中α1-MG和UAlb判断早期肾损害比较敏感.

Objective To investigate the correlation between Helicobacter pylori(Hp)infection and Henoch-Schonlein purpura(HSP)and its influence on early renal damage in children.Methods A total of 151 children with HSP were enrolled,among whom 52 HSP cases complicating with Hp infection were randomly divided into group A and group B,given Hp eradication treatment on the basis of routine treatment,and routine treatment,respectively.Another 99 HSP cases without HP infection treated with routine treatment were selected as C group.The urinary microprotein including urinaryβ2 microglobulin(β2-MG),urinaryα1 microglobulin(α1-MG),urinary micro transferrin(TRF),urinary albumin(UAlb),urinary immunoglobulin G(UIgG),were examined at the initial diagnosis,1,3,and 6 months of the disease course.The examination results of differed courses were compared in three groups.Results Among 151 children with HSP,52 cases were Hp-positive,with a detection rate of 34.4%.In terms of early renal dysfunction rate,group B was higher 5 than group C(P<0.05).At 3 months,the level ofα1-MG in group B was higher than that in group A and C,and the level of UAlb in group B was higher than that in group C,the differences were statistically significant(P<0.05);at 6 months,the level ofβ2-MG in group B was higher than that in group A and C(P<0.05).Conclusion HSP children with Hp infection are more prone to occur renal damage than those without Hp infection,and Hp eradication therapy can reduce the incidence of renal damage.[JP4]Early stage of renal damage in children with Henoch-Schonlein purpura mainly involves glomerulus glomerulus along with tubule.Moreover,α1-MG and UAlb are sensitive indicators in judging early renal damage in urinary microprotein.