过敏性紫癜患儿幽门螺杆菌感染、肠道菌群多样性及消化道出血的影响研究  

Study on the impact of Helicobacter pylori infection,gut microbiota diversity,and gastrointestinal bleeding in children with allergic purpura

作　　者：赵丽娜 赵建红 赖维阳 袁因 陈奕乔 朱伟伟 ZHAO Lina;ZHAO Jianhong;LAI Weiyang;YUAN Yin;CHEN Yiqiao;ZHU Weiwei(Department of Pediatrics,Hebei University of Engineering Affiliated Hospital,Handan O56000,Hebei,China;Department of General Surgery,Affiliated Hospital of Hebei University of Engineering;Children's Department of Cangzhou People's Hospital)

机构地区：[1]河北工程大学附属医院儿一科,河北邯郸056000 [2]河北工程大学附属医院普外科 [3]沧州市人民医院儿科

出　　处：《中国病原生物学杂志》2025年第3期328-332,337,共6页Journal of Pathogen Biology

基　　金：河北省卫生健康委员会科研项目(No.20211684)。

摘　　要：目的研究过敏性紫癜(HSP)患儿幽门螺杆菌(Hp)感染、肠道菌群多样性及消化道出血的影响。方法选取2021年1月~2024年1月期间在本院诊治的232例HSP患儿,按照消化道是否出血分为出血组104例和非出血组128例,分析两组HP感染情况、肠道菌群含量,并采用Kendall's tau-b、Spearman分析HSP患儿的Hp感染、肠道菌群多样性与消化道出血的相关性,采用二元Logisic回归分析HSP患儿发生消化道出血的影响因素。结果出血组发病季节、皮疹分布情况、呕吐、Hp感染情况和非出血组相比,均有统计学意义(P<0.05),出血组乳酸杆菌、双歧杆菌、CD4^(+)/CD8^(+)和非出血组相比更低(P<0.05),出血组大肠埃希菌、高敏C反应蛋白(CRP)和非出血组相比更高(P<0.05)。经Kendall's tau-b分析,HSP患儿Hp感染和消化道出血不具有关联性(r=0.080,P=0.202);经Spearman分析,HSP患儿乳酸杆菌、双歧杆菌和消化道出血呈负相关(r=-0.222、-0.318,P=0.001、<0.001),大肠埃希菌和消化道出血呈正相关(r=0.415,P<0.001)。经多因素二元Logisic回归分析,发病季节夏/冬(OR=14.788,P=0.001)、皮疹特重度(OR=10.772,P=0.022)、Ⅰ型Hp感染(OR=5.367,P=0.027)、大肠埃希菌增高(OR=6.990,P<0.001)、CRP升高(OR=4.312,P<0.001)是HSP患儿发生消化道出血的危险因素,乳酸杆菌增高(OR=0.112,P<0.001)、双歧杆菌增高(OR=0.097,P<0.001)、CD4^(+)/CD8^(+)升高(OR=0.017,P=0.008)是HSP患儿发生消化道出血的保护因素。结论HSP患儿消化道出血和肠道菌群含量密切相关,对于HSP患儿,临床需关注患儿的发病季节、Hp感染类型、大肠埃希菌、乳酸杆菌、双歧杆菌、CRP、CD4^(+)/CD8^(+),并给予针对性措施,以降低发生消化道出血的风险。Objective Study the effects of Helicobacter pylori(Hp)infection,gut microbiota diversity,and gastrointestinal bleeding in children with Henoch Schonlein purpura(HSP).Methods Selected 232 children with HSP treated in our hospital from January 2021 to January 2024,divided into a bleeding group of 104 cases and a non bleeding group of 128 cases based on whether there was gastrointestinal bleeding.Analyzed the infection status and gut microbiota content of two groups of Hp,and Kendall's tau-b and Spearman were used to analyze the correlation between Hp infection,gut microbiota diversity,and gastrointestinal bleeding in children with HSP,Used binary logistic regression analysis to investigate the influencing factors of gastrointestinal bleeding in children with HSP.Results The incidence season,rash distribution,vomiting,and Hp infection in the bleeding group compared to the non bleeding group were statistically significant(P<0.05).The bleeding group had lower levels of lactobacilli,bifidobacteria,CD4^(+)/CD8^(+)compared to the non bleeding group(P<0.05).The bleeding group had higher levels of E.coli and high-sensitivity Creactive protein(CRP)compared to the non bleeding group(P<0.05).According to Kendall's tau-b analysis,there is no correlation between Hp infection and gastrointestinal bleeding in children with HSP(r=0.080,P=0.202);According to Spearman's analysis,there is a negative correlation between lactobacilli,bifidobacteria,and gastrointestinal bleeding in HSP patients(r=-0.222,-0.318,P=0.001,<0.001),while there is a positive correlation between E.coli and gastrointestinal bleeding(r=0.415,P<0.001).Through multiple factor binary logistic regression analysis,the onset season of summer/winter(OR=14.788,P=0.001),severe rash(OR=10.772,P=0.022),type I Hp infection(OR=5.367,P=0.027),elevated E.coli(OR=6.990,P<0.001),and elevated CRP(OR=4.312,P<0.001)are risk factors for gastrointestinal bleeding in children with HSP.Elevated lactobacilli(OR=0.112,P<0.001),bifidobacteria(OR=0.097,P<0.001),and CD4^(+)/CD8^(+)(OR=0.017,

关 键 词：过敏性紫癜 幽门螺杆菌感染 大肠埃希菌 乳酸杆菌 双歧杆菌消化道出血 

分 类 号：R72[医药卫生—儿科]