幽门螺杆菌感染对过敏性紫癜患儿的影响

目的探讨幽门螺杆菌(H.pylori)感染对过敏性紫癜(henoch-schonlein purpura, HSP)患儿肠道菌群、疗效及疾病复发情况的影响。方法选取2017年1月至2018年6月我院收治的100例HSP患儿作为观察组,同时随机选取同时段于我院体检的100例健康儿童作为对照组。采用13C同位素呼吸试验法检测H.pylori感染情况,根据H.pylori感染情况进一步将观察组患儿分为感染组和非感染组。收集观察组患儿粪便样本,采用Illumina MiSeq平台对患儿肠道菌群的16S rRNA V4序列进行测序,分析肠道菌群组成,同时分析患儿疗效及疾病复发情况与H.pylori感染的关系。结果观察组患儿H.pylori感染率显著高于对照组(47.00%vs 30.00%,χ²=6.100,P=0.015)。治疗后非感染组患儿有效率明显高于感染组(92.45%vs 78.72%,χ²=3.900,P=0.048),复发率显著低于感染组(24.53%vs 44.68%,χ²=4.510,P=0.034)。感染组和非感染组患儿肠道菌群多样性差异无统计学意义,但在门、科水平上肠道菌群结构相对丰度差异有统计学意义。非感染组患儿肠道厚壁菌门、放线菌门相对丰度显著高于感染组,同时其拟杆菌科、瘤胃菌科、链球菌科、双歧杆菌科、巴斯德菌科相对丰度也显著高于感染组(均P<0.05)。结论 H.pylori感染与儿童HSP的发生存在一定相关性。H.pylori感染可影响HSP患儿肠道菌群组成,同时降低疾病治疗效果以及增加复发风险。

The impact of Helicobacter pylori infection on children with henochschonlein purpura

Objective To explore the impact of H.pylori infection on intestinal flora, efficacy and disease recurrence in children with henoch-schonlein purpura(HSP). Methods A total of 100 children with HSP who were treated in our hospital from January 2017 to June 2018 were selected as observation group, and 100 healthy children in the same period were randomly selected as the control group. H.pylori infection was detected using 13C breath test. According to the results, the children in observation group were further divided into infection group and non-infection group.The fecal samples of children in observation group were collected and the 16 S rRNA V4 sequence of intestinal flora was detected using Illumina MiSeq system.The composition of intestinal flora was analyzed, and the relationship between efficacy and disease recurrence and H.pylori infection were analyzed. Results The infection rate of H.pylori in the observation group was significantly higher than that in the control group(47.00% vs 30.00%, χ²=6.100, P=0.015). After treatment, the efficiency rate in non-infection group was significantly higher(92.45% vs 78.72%, χ²=3.900, P=0.048), and the recurrence rate was significantly lower(24.53% vs 44.68%, χ²=4.510, P=0.034) than that in infection group, respectively.There was no significant difference in the diversity index of intestinal flora between the two groups, but in the relative abundance of intestinal flora at the phylum and family levels. The relative abundances of intestinal Actinomycetes, Bacteriaceae, Ruminococcaceae, Streptococcus, Bifidobacterium and Pasteuriaceae in the non-infection group were significantly higher than those in the infection group(all P< 0.05). Conclusion There is a correlation between H.pylori infection and the occurrence of HSP in children. H.pylori infection can affect the composition of intestinal flora in children with HSP, reduce the therapeutic effect and increase the risk of recurrence.