哮喘儿童Hp感染发病情况及对哮喘控制效果的影响

Incidence of Hp Infection in Children with Asthma and Effect on Asthma Control

目的调查哮喘儿童幽门螺杆菌(Helicobacter pylori,Hp)感染情况,并探讨Hp感染对匹多莫德控制哮喘效果的影响。方法选取2015年9月〜2018年9月我院收治的118例哮喘儿童为研究对象(哮喘组),另选取同期来我院体检的100例健康儿童为对照组,比较两组Hp感染情况。根据Hp是否为阳性,将哮喘组患儿分为哮喘感染Hp亚组和哮喘未感染Hp亚组。比较哮喘感染Hp亚组和哮喘未感染Hp亚组外周血T细胞亚群及血清细胞因子水平,常规治疗基础上加用匹多莫德治疗12周后,比较两亚组哮喘控制情况。结果哮喘组Hp感染率为38.14%,显著高于健康对照组(P<0.05)。哮喘感染Hp亚组Thl、Thl/Th2分别为(12.37±1.53)%和3.79±0.42,低于哮喘未感染Hp亚组,Th2、Thl7和Thl7/Treg分别为(3.26±0.73)%、(8.57±1.02)%和4.12±0.65,高于哮喘未感染Hp亚组,差异均有统计学意义(P<0.05);哮喘感染Hp亚组血清IL-2和INF-γ水平分别为(20.15±3.82)ng/ml、(14.28±4.42)ng/ml,均低于哮喘未感染Hp亚组,IL-4、IL-5、IL-17和IL-25水平分别为(48.28±7.27)ng/ml.(83.15±10.73)ng/ml.(81.53±9.64)ng/ml(43.48±6.77)ng/ml,均高于哮喘未感染Hp亚组,差异有统计学意义(P﹤0.05);经治疗,哮喘感染Hp亚组哮喘控制率为76.09%,低于哮喘未感染Hp亚组,差异有统计学意义(P﹤0.05)。结论哮喘儿童Hp感染发生率较高,Hp感染会导致机体免疫功能紊乱,促进哮喘发生,并且降低哮喘控制效果。

Objective To investigate Helicobacter pylori(Hp)infection in children with asthma and explore the effects of Hp infection on pidotimod in the control of asthma.Methods 118 children with asthma admitted to the hospital from Sep.2015 to Aug.2018 were selected as the asthma group,and 100 healthy children were enrolled in the control group.Hp infection was compared between the two groups.According to whether Hp was positive or not,children with asthma were divided into the asthma Hp infection subgroup and asthma non-Hp infection subgroup.Levels of peripheral blood T lymphocyte subsets and serum cytokines were compared between the subgroups.After 12 weeks of routine treatment and pidotimod,the asthma control was compared between the subgroups.Results Hp infection rate in the asthma group was 38.14%,which was significantly higher than that in the healthy control group(P<0.05).The levels of Thl and Thl/Th2 were(12.37±1.53)%and(3.79±0.42)in the asthma Hp infection subgroup,which were lower than those in the asthma non-Hp infection subgroup.The levels of Th2,Thl7 and Thl7/Treg were(3.26±0.73)%,(8.57±1.02)%and(4.12±0.65),which were significantly higher than those in the asthma non-Hp infection subgroup(P<0.05).The levels of serum IL-2 and INF-γ were(20.15±3.82)ng/mL and(14.28±4.42)ng/mL in the asthma Hp infection subgroup,which were lower than those in the asthma non-Hp infection subgroup.The levels of IL—4,IL-5,IL—17 and IL—25 were(48.28±7.27)ng/mL,(83.15±10.73)ng/mL,(81.53±9.64)ng/mL and(43.48±6.77)ng/mL,which were higher than those in the asthma non一Hp infection subgroup(P<0.05).After treatment,the asthma control rate in the asthma Hp infection subgroup(76.09%)was lower than that in the asthma non-Hp infection subgroup(P<0.05).Conclusion The incidence rate of Hp infection is high in children with asthma.Hp infection can lead to the disorder of immune function,promote the occurrence of asthma and reduce the asthma control effect.