幽门螺旋杆菌感染对过敏性紫癜患儿肾功能的影响  

Helicobacter pylori infection on the renal function in children with Henoch Schonlein purpura

作　　者：舒建义[1] 龙晓玲[1] 张泉山[1] 潘晓芬[1] 

机构地区：[1]南方医科大学附属中山博爱医院儿科,广东中山528403

出　　处：《皖南医学院学报》2016年第2期148-150,共3页Journal of Wannan Medical College

摘　　要：目的：探讨幽门螺旋杆菌（Helicobacter pylori,Hp）感染对过敏性紫癜（henoch-schonlein purpura,HSP）小儿肾功能的影响。方法：选择我院收治的HSP患儿80例为研究组,取同期我院体检的健康儿童50例为对照组,两组均行13C呼气试验（13C-UBT）检测,根据检测结果将研究组分为Hp阳性组和Hp阴性组;两组患儿均根据患者肾损害病情进行相关治疗,其中Hp阳性组采用Hp根除三联疗法。比较各组Hp感染率,Hp感染对HSP患儿肾脏损害发生率及肾损害恢复率,并记录HSP患儿治疗前后肾功能指标。结果：研究组Hp感染率63.75%,对照组40.00%,研究组Hp感染率显著高于对照组（χ^2=7.002,P=0.008）。伴Hp感染HSP患儿肾脏损害发生率为66.67%,显著高于无Hp感染HSP患儿（34.48%,P〈0.05）;伴Hp感染HSP患儿经Hp根除治疗后门诊随访3个月肾损害恢复率为85.29%,无Hp感染HSP患儿门诊随访3个月肾损害恢复率为50.00%,两组相比差异亦有统计学意义（P〈0.05）。Hp阳性HSP患儿经Hp根除治疗后第1个月及第3个月UMA、UMA/UCr、24 h尿蛋白显著降低,且低于同时段Hp阴性组（P〈0.05）;Hp阴性的HSP患儿常规治疗后第3个月UMA、UMA/UCr显著降低（P〈0.05）,而其余指标治疗前后无统计学差异（P〉0.05）。结论：Hp感染对HSP患儿肾损害有明显影响,及时发现并根除Hp感染,对避免HSP患儿发生肾损害及促进损害后的修复具有重要作用。Objective：To investigate the incidence of kidney involvement in children with Helicobacter pylori（Hp）complicated with Henoch Schonlein purpura（HSP）.Methods：Eighty children with HSP admitted to our hospital were included in study group,and another 50 healthy children undergoing health examination in the corresponding period in our hospital were recruited as controls,and both groups of children received13C-urea breath test（13CUBT）.Then children in the study group were assigned to group of Hp-positive or Hp-negative,and given medication in compliance with the renal involvement.Children with Hp-positive infection underwent therapy with triple regimen.Then the two groups were compared regarding the rate of H.pylori infection,incidence of HSP and renal impairment and its recovery by reference to the renal function indicators tested before and after medication.Results：Study group had higher Hp infection rate than the control subjects（63.75% vs.40%,χ^2= 7.002,P = 0.008）.The incidence of renal impairment was 66.67%in children of HSP associated with H.pylori infection compared to 34.48% in those free of H.pylori infection（P 〈 0.05）.Renal injury was recovered in85.29% of children with HSP after eradication of the H.pylori,and in 50.00% of children without H.pylori infection during the 3-month clinic followup,the difference was significant（P 〈 0.05）.The levels of UMA,UMA/UCr and 24-hour urinary protein were decreased significantly in children of HSP associated with positive H.pylori at month 1 and 3 after medication,and lower than those of H.pylori-negative（P 〈 0.05）,whereas the decrease of the indicators in children of HSP with negative H.pylori treated conventionally was found at month 3（P 〈 0.05）,and the remaining indexes had no statistical difference before and after medication（P 〉 0.05）.Conclusion：H.pylori infection may lead to significant renal impairment in children associated with HSP,and eradication of H.pylori may favor to the recovery of renal function.

关 键 词：幽门螺旋杆菌 过敏性紫癜 肾功能 

分 类 号：R725.5[医药卫生—儿科]