幽门螺杆菌感染与儿童哮喘发病的相关性分析  

Correlation between Helicobacter pylori infection and asthma in children

作　　者：王志刚 申改青[1] 黄玉焕[1] WANG Zhigang;SHEN Gaiqing;HUANG Yuhuan(Neonatal Intensive Care Unit,Nanyang First People's Hospital,Nanyang,Henan 473200,China)

机构地区：[1]南阳市第一人民医院新生儿重症监护室,河南南阳473200

出　　处：《安徽医药》2023年第12期2479-2482,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨幽门螺杆菌(H.pylori)感染与哮喘发病的影响,分析H.pylori感染对免疫功能指标、辅助性T细胞1(Th1)/辅助性T细胞2(Th2)和辅助性T细胞17(Th17)/调节T细胞(Treg)平衡的影响。方法收集2020年1月至2021年12月,在南阳市第一人民医院接受治疗的哮喘病儿(哮喘组)142例,及健康儿童(对照组)120例。采用14C呼气试验检测H.pylori感染情况,比较哮喘组和对照组中H.pylori阳性率。哮喘病儿根据是否合并H.pylori感染,分为H.pylori阴性组和H.pylori阳性组,比较两组间免疫功能指标、Th1/Th2及Th17/Treg。结果哮喘组H.pylori阳性率10.6%显著低于对照组32.5%(χ^(2)=19.13,P<0.001)。轻度哮喘组、中度哮喘组和重度哮喘组H.pylori阳性率分别为22.2%(10/45)、6.6%(4/61)和2.8%(1/36),三组间比较均差异有统计学意义(χ^(2)=9.82,P=0.007),且重度哮喘组H.pylori阳性率低于轻度哮喘组(χ^(2)=6.44,P=0.011)。H.pylori阳性组CD4+、CD8+、免疫球蛋白M(IgM)和免疫球蛋白G(IgG)水平均高于H.pylori阴性组(P<0.05)。H.pylori阳性组白细胞介素(IL-4)、IL-5、IL-10和Th2水平低于H.pylori阴性组,γ干扰素(IFN-γ)、Th1和Th1/Th2水平高于H.pylori阴性组(P<0.05)。H.pylori阳性组Treg(5.2±1.3)%和IL-35(153.9±16.8)ng/L水平高于H.pylori阴性组Treg(4.1±1.2)%和IL-35(135.8±21.4)ng/L,H.pylori阳性组IL-17水平(132.4±16.8)ng/L低于H.pylori阴性组IL-17水平(152.3±25.6)ng/L(P<0.05)。结论哮喘病儿H.pylori阳性率较低,H.pylori阳性可平衡免疫功能、调节Th1/Th2和Th17/Treg平衡。Objective To explore the effect of Helicobacter pylori(H.pylori)infection on the pathogenesis of asthma,and to analyze the effect of H.pylori infection on immune function indexes,T helper 1(Th1)/T helper 2(Th2)and T helper 17(Th17)/regulatory T cell(Treg)balance.Methods From January 2020 to December 2021,142 asthmatic children(asthma group)who were treated in Nanyang First People's Hospital and 120 healthy control children(control group)were enrolled in the study.H.pylori infection was detected by 14C breath test,and the positive rates of H.pylori in asthma group and control group were compared.Children with asthma were assigned into H.pylori negative group and H.pylori positive group according to whether they were complicated with H.pylori infection.The immune function indexes,Th1/Th2 and Th17/Treg ratios were compared between the two groups.Results The positive rate of H.pylori in the asthma group was significantly lower than that in the control group(10.6%vs.32.5%,χ^(2)=19.13,P<0.001).The positive rates of H.pylori in mild asthma group,moderate asthma group and severe asthma group were 22.2%(10/45),6.6%(4/61)and 2.8%(1/36),respectively;the difference among the three groups was found to be statistically significant(χ^(2)=9.82,P=0.007),and the positive rate of H.pylori in the severe asthma group was lower than that of the mild asthma group(χ^(2)=6.44,P=0.011).The levels of CD4+,CD8+,immunoglobulin M(IgM)and immunoglobulin G(IgG)in the H.pylori positive group were higher than those in the H.pylori negative group(P<0.05).The levels of Interleukin(IL-4),IL-5,IL-10 and Th2 in the H.pylori positive group were lower than those in the H.pylori negative group,and the levels of gamma interferon(IFN-γ),Th1 and Th1/Th2 ratio were higher than those in the H.pylori negative group(P<0.05).The levels of Treg and IL-35 in the H.pylori-positive group were higher than those in the H.pylori-negative group[(5.2±1.3)%vs.(4.1±1.2)%,(153.9±16.8)ng/L vs.(135.8±21.4)ng/L],and the level of IL-17 in the H.pylori-positive group was

关 键 词：哮喘 幽门螺杆菌 辅助性T细胞1/辅助性T细胞2 辅助性T细胞17/调节T细胞 儿童 

分 类 号：R725.6[医药卫生—儿科]