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

  • 摘要:
      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。

     

    Abstract:
      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 urinary β2 microglobulin (β2-MG), urinary α1 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 of α1-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 of β2-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. Early stage of renal damage in children with Henoch-Schonlein purpura mainly involves glomerulus or glomerulus along with tubule. Moreover, α1-MG and UAlb are sensitive indicators in judging early renal damage in urinary microprotein.

     

/

返回文章
返回